Blood pressure measuring apparatus

ABSTRACT

Adaptive attachments used in combination with a blood pressure cuff enable various blood pressure measurements to be taken in a hospital or other setting having various single and/or dual lumen manual or electronic blood pressure measuring equipment with a single, patient-worn cuff.

CROSS REFERENCE TO RELATED APPLICATIONS

This Application is a continuation of U.S. application Ser. No.13/965,651, entitled “Blood Pressure Measuring Apparatus,” filed on Aug.13, 2013, which claims priority as a CIP application to U.S. applicationSer. No. 11/513,608, which was filed on Aug. 31, 2006, issued as U.S.Pat. No. 8,535,233 on Sep. 17, 2013, which claims priority as a CIPapplication to and commonly owned U.S. patent application Ser. No.11/230,117, which was filed on Sep. 19, 2005, issued as U.S. Pat. No.7,780,603 on Aug. 24, 2010, and claimed priority as a CIP application toU.S. patent application Ser. No. 10/456,704, which was filed on Jun. 5,2003, issued as U.S. Pat. No. 7,722,542 on May 25, 2010, and claimedpriority as a CIP application to U.S. patent application Ser. No.09/929,501, which was filed on Aug. 14, 2001, issued as U.S. Pat. No.6,615,666 on Sep. 9, 2003, and claimed priority as a CIP application toU.S. patent application Ser. No. 09/669,474, which was filed on Sep. 25,2000, and issued as U.S. Pat. No. 6,422,086 on Jul. 23, 2002, whereineach of the Ser. Nos. 11/230,117, 10/456,704, 09/929,501 and 09/669,474applications is incorporated by reference herein in their entirety.

FIELD OF THE INVENTION

The invention relates to the field of measuring instruments, and moreparticularly to a technique and related apparatus for enabling aplurality of blood pressure measurements to be interchangeably performedwith various discrete systems, such as within a hospital environment.

BACKGROUND OF THE INVENTION

Pressure measuring devices such as sphygmomanometers, that are used tomeasure the arterial blood pressure of a patent, typically include apneumatic bulb which inflates a pressure chamber of an attached sleevethat is fitted over a limb (i.e., an arm or a leg) of the patient. Adiaphragm or bellows assembly, responsive to changes in fluid pressureof the pneumatic bulb and the sleeve pressure chamber, is positioned ina gage housing which is fluidly connected to the pressure chamber of thesleeve through flexible tubes or hoses. In a mechanical gage housing, apointer of a dial indicator is interconnected to the bellows assemblythrough a movement mechanism that is retained within the gage housing,whereby inflation of the bellows causes corresponding circumferentialmovement of the pointer, enabling a blood pressure measurement procedureto be carried out by a caregiver.

Typically, the above referred to movement mechanisms are quite intricateand complex, and are akin in terms of their manufacture and precision toSwiss watches. For example, and in one such movement mechanism, a pairof diaphragm springs are attached adjacent opposing ends of a spindle. Abottom end of the spindle is placed in contact with the bellows assemblyand a twisted bronze band perpendicularly disposed at the top end of thespindle is connected in parallel by a horizontally disposed spring bentpart. As the spindle deflects axially in response to the inflation ofthe bellows, the bent spring part is also caused to deflect, therebycausing the band to twist. The pointer, attached to the bronze band,therefore is caused to rotate in relation to an adjacent dial face.

Devices, such as the foregoing, include numerous moving and relativelycomplex components, some or each of having numerous bearing surfaces.Therefore, such known devices must be manufactured with relativelystrict tolerance margins and significant associated costs in terms ofboth precision and failure rate in order to minimize en-ors.

In addition, any adjustments required after assembly of the abovemechanisms, such as to null the pointer or adjust the sensitivity of thedevice, require substantial tear down or at least some undesireddisassembly.

Furthermore, discrete and separate elements are typically requiredwithin the instrument housing for independently supporting the movementmechanism and the bellows assembly, respectively, and for defining anexpansion chamber for the bellows assembly there between.

A more recent and simplified movement mechanism is described in U.S.Pat. No. 5,996,829, incorporated by reference in its entirety. Thismechanism includes a vertically disposed axial cartridge having aspirally wrapped ribbon spring with one end mounted to an axiallymovable elongate shaft and the remaining end of the spring beingattached to a fixed tubular sleeve. A bottom portion of the elongateshaft is positioned relative to an expandable diaphragm or bellows,wherein subsequent axial translation of the shaft, caused by movement ofthe diaphragm, elongates the spirally wound ribbon spring and producesrepeatable circumferential movement of a pointer supported at the topend of the shaft. The above movement mechanism is far smaller and morelightweight than those previously known due to its simplifiedconstruction.

A further advance, described in U.S. Pat. No. 6,168,566, alsoincorporated by reference in its entirety, permits the design of ahousing retaining the movement mechanism described in the '829 patent tobe even more compact.

One feature common to the above pressure measuring devices is the needto fluidly interconnect the gage housing containing the movementmechanism, the dial face and the indicating member with the interior ofthe inflatable sleeve. This interconnection is typically done using anelongated hose that is connected to a barb or coupling located on thesleeve exterior at one end of the hose and to an inlet port disposed onone end of the gage housing. It is a general object in the field tosimplify the manufacture of these devices and to better integrate thedesign thereof.

More recently, electronic versions of pressure measuring devices havebecome much more prevalent and conspicuous in their use in the field.These devices such as those manufactured by Omron, Inc. among others canbe mounted to the arm or wrist of a patient. These devices have abattery powered electronically based device that converts the outputfrom the sleeve into a pressure reading output to the user. There isstill reliance, however, upon inflation and deflation of an inflatablesleeve and more particularly, there is a fluid interconnection betweenthe interior of the sleeve and the interior of the gage housing. Inaddition and to date, all of these devices have always been part of anintegrated assembly, including the sleeve, whereby replacement hasrequired replacement of not only the sleeve, but also the tetheredelectronic components.

With the emergence of such electronic equipment, there are now numerouseffective ways to measure blood pressure through use of a variety ofdifferent types of both manual and electronic blood pressure measurementequipment and devices. There are two general types of manual ormechanical blood pressure measurement equipment that remain incirculation and that continue to be manufactured and usedindiscriminately today. A first type of measurement device is incommunication with a cuff/sleeve through a single lumen hose attachmentthat is utilized to inflate and deflate pressure in the cuff. A secondtype of blood pressure measurement device is in communication with acuff/sleeve through a dual lumen hose attachment in which one lumen isagain utilized to inflate and deflate pressure in the cuff and thesecond lumen allows for monitoring of the pressure within the cuff.Similarly, there are also different types of electronic blood pressuremeasurement devices, some of which rely upon hose attachments having onelumen, and others that utilize a dual lumen hose attachment. Moreover,some manufacturers have designed manual and electronic blood pressuremeasurement equipment that is connected to a hose attachment by one typeof connector (e.g., a screw/luer type), whereas other manufacturers mayrequire such connection be made to their equipment via a different typeof connector (e.g., a luer lock or bayonet type).

Currently, there is no standard that dictates how manual or electronicblood pressure measurement devices must be designed. Moreover, hospitalsand HMO treatment centers have varying needs and are budget conscious toan extent whereby most have not withdrawn older, still functioning bloodpressure measurement devices from use despite also having begun toutilize newer, more sophisticated equipment. These circumstances haveled to a situation in which many hospitals and HMO treatment centershave several different types (e.g., manual, electronic, reliant upon asingle lumen hose attachment, reliant upon a dual lumen hose attachment,utilizing different connectors, etc.) of blood pressure measurementequipment for use at various stations on their premises.

The preceding situation, in turn has created a problem in which vitaltime and manpower is being lost while switching between and among thesedifferent types of blood pressure measurement equipment. Although thisproblem can exist in any medical setting, it is most salient within ahospital environment, where it is often important to continually monitorthe blood pressure of a patient, since a sudden change in the patient'sblood pressure could be indicative of an improvement or set back in thepatient's condition, or could aid in the overall diagnostic and/ortreatment thereof.

At present, such continuous monitoring ls generally commenced bywrapping a first cuff/sleeve (having at least one preattached singlelumen or dual lumen hose) onto a patient in order to take the patient'sblood pressure through use of a first blood pressure measurement device,either within an ambulance during transport to a hospital or uponarrival at the initial assessment/treatment area (e.g., triage unit,diagnosis station) of a hospital. It is generally necessary to removethe initial cuff/sleeve and attached hose combination prior totransporting the patient to his or her next destination within thehospital, e.g., a trauma room or an imaging room, at which a new sleeve(again with at least one single lumen or dual lumen pre-attached hose)of the proper size must be located and attached to enable blood pressuremonitoring to continue through use of a different blood pressuremeasurement device. For example, the first blood pressure measurementdevice may be a manual or electronic device and the second anincompatible (e.g., due to the number of lumens in the pre-attachedhose, the connector required, etc.) manual or electronic blood pressuredevice.

Under typical circumstances, such detaching, locating and reattachingsteps might be performed several times while the patient is beinginitially evaluated and/or after the patient is admitted to thehospital. This is because, as noted above, many hospitals routinelyutilize both manual and electronic blood pressure measurement equipment,some or all of which may be incompatible the with the currently worncuff/sleeve with at least one hose attachment (e.g., due to being manualversus electronic, the type of connector required, the number of lumenswithin the attached hose, etc.). Even in a best-case scenario, eachround of detaching, locating and reattaching steps are inconvenientbecause they command the attention, however brief, of medical personnelwho could otherwise be performing different tasks. And at worst, theseconds to minutes that can be spent in locating, attaching, detachingand reattaching each new cuff/sleeve with a pre-attached hose could havelife-impacting consequences for a patient.

Moreover, due to the chaos that often can be encountered when evaluatinga patient in a hospital, especially in an emergency department setting,it is not uncommon for the at least one pre-attached hose that isconnected to the cuff/sleeve to become kinked to an extent that wouldprevent further blood measurements from being taken with sufficientaccuracy. Because the hose is pre-attached to the sleeve, once kinkingoccurs it might becomes necessary to remove the sleeve with preattachedhose and then to locate and attach an entirely new sleeve with its ownpre-attached hose. This is problematic for the same reasons noted above,plus it can introduce even more chaos into the emergency departmentenvironment.

Thus, there is a need for a procedure to reliably measure blood pressureand that also will better enable a wide range of electronic or manualblood pressure measurements to be taken interchangeably and with minimaldisruptions through use of a wide range of manual or electronic bloodpressure measurement equipment and devices, such as those found in ahospital or HMO treatment center environment.

SUMMARY OF THE INVENTION

These and other needs are met by the present invention, which providessystems, methods and kits for interchangeably enabling blood pressuremeasurements to be performed on a patient through use of variousdifferent blood pressure measurement equipment or devices while enablingthe same cuff/sleeve to be worn by the patient the entire time, ifdesired. In other words, through use or implementation of the systems,methods and kits of the present invention, a patient can wear the samecuff/sleeve while numerous blood pressure measurements are performedusing a wide variety of manual or electronic blood pressure measurementequipment, regardless of the design or manufacturer of the variousequipment, thus obviating the need to repeatedly detach a cuff/sleeveand then locate and reattach a new sleeve/cuff. Additionally, thesystems, methods and kits of the present invention enable any of severalpieces of blood pressure measurement equipment to be individuallyconnected to any of multiple patients regardless of the size and type ofcuff each patient is wearing and/or irrespective of the design andmanufacturer of the pieces of blood pressure measurement equipment.

According to an exemplary aspect of the present invention, an inflatablecuff is adapted to be wrapped about a limb of a patient, wherein thecuff includes an interior chamber and an exterior surface. The cuff canbe disposable (i.e., meant for use only on that patient) or durable(i.e., reusable on more than one patient). A first adapter is connectedto the cuff, the first adapter including an opening that provides directfluid communication between the exterior surface and the interiorchamber of the cuff. A second adapter also can be provided and, when so,is releasably connected to and in direct fluid communication with thefirst adapter, wherein the second adapter allows individualinterchangeable fluid communication with any of a plurality of differentblood pressure measurement devices to enable blood pressure measurementsto be performed. If desired, the second adapter can comprise a chamberin direct fluid communication with the cuff opening, wherein the chambercan include, if also desired, at least one screening component forcollecting contaminants.

The first adapter (and, if present, the second adapter) enable a cuff ofany size and/or type to be quickly and easily individually placed influid communication with any of a variety of different blood pressuremeasurement device so as to facilitate the process of individuallytaking blood pressure measurements for multiple patients. Thus, inaccordance with this exemplary aspect, a truly interchangeable,versatile and easy-to use blood pressure measurement system is provided.

Optionally, this individual interconnection can be accomplished throughthe use of at least one hose attachment, the attachment having a firstend for connection to the second adapter and a second end forinterchangeable individual connection to any of a plurality of bloodpressure measuring devices. Thus, interchangeability is provided in atleast two important ways. First, in lieu of replacing a cuff/sleeve inorder to enable a number of blood pressure measurements to be taken froma single patient via different blood pressure measurement devices orequipment, the system of the present invention merely entails attachmentof a second adapter and/or hose. Second, and in a similar vein, the hoseand second adapter attachment more easily allow for blood pressuremeasurements to be taken from multiple patients using the same ordifferent blood pressure measurement equipment and regardless of thesize and/or type of cuffs being worn by the patients. Suchinterchangeability provides valuable time savings and design flexibilityas compared to those systems that are currently utilized.

In accordance with this exemplary aspect of the present invention, thecuff can comprise a single sleeve, wherein the interior chamber of thecuff can be formed, by way of non-limiting example, by connecting afirst edge of the sleeve to a second edge of the sleeve. Alternatively,the cuff can be formed of two connected sleeves, wherein the interiorchamber is defined between the two sleeves. The cuff can assume any sizeto fit a plurality of patients, including but not limited to sizes thatare currently referred to in the art as infant size, pediatric size,small adult size, adult size, large adult size and thigh size, and canbe dimensioned to fit either the arm or the thigh of the patient. Thecuff size generally is indicated by textual indicia, color indicia,pictorial indicia, or textual and pictorial indicia on the cuff

Also in accordance with this exemplary aspect, the first adapter can bedefined by a socket, the socket being disposed substantially within theexterior surface of the cuff, or a fitting, at least a portion of whichprotrudes (e.g., in the range of about 1 mm to about 15 mm) from theexterior surface of the cuff by a predetermined distance. lne firstadapter can include an optional radial seal, which, when present, is incommunication with the exterior surface of the cuff and has a diametergreater or smaller than the diameter of the first adapter openingdepending on specific attachment conditions. The first adapter canfurther include a main body that surrounds the radial seal, if present,and is in contact with the exterior surface of the cuff. Optionally, thefirst adapter can include a flange (e.g., an underlying flange) toenable or facilitate connection of the first adapter to the interiorchamber of the cuff, wherein such connection can occur, by way ofnon-limiting example, by welding (e.g., RF welding, ultrasonic welding,chemical welding, heat welding), bonding or sealing.

In further accordance with this exemplary aspect, the entire firstadapter can be made of a single material, or, alternatively, of two ormore different materials, wherein “different” means non-identical in oneor more regards. By way of example, the main body of the first adaptercan be made of a first material and the one or more portions of theremainder of the first adapter (e.g., the rim and/or the ridge of thefirst adapter) can be made of a second, comparatively more rigid (i.e.,less flexible) material. Also, the second adapter can include, ifdesired, one or more screening components to collect unwanted foreignmaterials and/or contaminants such as dust and/or debris, wherein theone or more screening components can be integral to and/or attached tothe second adapter.

In yet further accordance with this exemplary aspect, the first andsecond adapters are releasably connected, whereby the second adapter isat least partially (and, if desired, substantially entirely) rotatablewhile connected to the first adapter so as to prevent or at leastinhibit kinking of hose attached to the second adapter. The releasableconnection between the first adapter and the second adapter can beaccomplished, by way of nonlimiting example, by snap fitting, frictionfit, detent action, threaded engagement or by fitting a flange of thesecond adapter over an elastomeric lip of the first adapter. By way ofanother non-limiting example, the releasable connection between thefirst and second adapter can occur by virtue of the second adapterincluding recesses within which fingers or other protruding portions ofthe first adapter can fit, e.g., via snap fitting or detent. By way ofyet another non-limiting example, the releasable connection between thefirst adapter and the second adapter can be accomplished by providingthe second adapter with a plunger-like mechanism to expand inwardly oroutwardly following a predetermined action (e.g., upon the pressing of abutton or upon activation of a trigger) in order to hold or release thefirst adapter in/from tactile communication with the second adapter.

As noted above, and in still further accordance with this exemplaryaspect of the invention, the second adapter is adapted forinterchangeable, individual connection (i.e., non-simultaneousconnection) to any of a plurality of blood pressure measuring devices.Such individual connection can occur by attaching an end of at least onehose to at least one protruding barb of the second adapter or at leastone recess defined within the second adapter. The attached hose can havea single lumen or more than one lumen defined there within; by way ofnon-limiting example, the second adapter generally will include one barbor have one recess defined there within if the attached hose has asingle lumen, whereas the second adapter generally would include twobarbs or recesses if the attached hose has two lumens.

If desired, the second adapter can be designed to serve its role as aconduit between the first adapter and the hose attachment while at thesame time segmenting flow between these two areas. This can occur, byway of non-limiting example, by designing the second adapter to includea first chamber in direct fluid communication with the opening of thefirst adapter and a first lumen of attached hose, and to include asecond chamber in direct fluid communication with the opening of thefirst adapter and a second lumen of attached hose. Provision is made ofa dividing zone between the first chamber and said second chamber,wherein the dividing zone is effective to mm 1 mize fluid communicationbetween said first chamber and said second chamber. The dividing zonecan be formed of a first wall in common with the first chamber and asecond wall in common with the second chamber, wherein a channel isdefined between the first chamber and the second chamber to separate thefirst chamber and a second chamber by a predetermined distance (e.g.,about 1 mm to about 10 mm). The first chamber and the second chamber canhave identical shapes or different shapes, wherein an exemplaryidentical shapes include, but are not limited to, semi-circular andhalf-elliptical.

In accordance with an exemplary aspect of a blood pressure measurementmethod of the present invention, blood pressure measurements can beperformed usmg one or more similar or different blood pressuremeasurement devices by providing a cuff that includes an interiorchamber and an exterior surface, wherein a first adapter issubstantially disposed within and exposed through the exterior surfaceof said cuff. The first adapter includes an opening extending into theinterior chamber of the cuff to provide direct fluid communicationbetween the exterior surface and the interior chamber of the cuff. Thecuff and first adapter generally will have the same features as thosedescribed above with respect to the exemplary system of the presentinvention.

In furtherance of the exemplary method, the cuff is placed in tactilecommunication with a patient (e.g., by being wrapped around a patient'sarm) and a second adapter is releasably connected to the first adaptersuch that there is direct fluid communication between the first adapterand said second adapter. That, m turn, enables fluid communicationbetween the second adapter and the interior of the cuff/sleeve due tothere being direct fluid communication between the first adapter and theinterior of the cuff/sleeve. The features of the second adapter and themethods of connecting it to the first adapter also are generally similarto those discussed above with respect to the exemplary system of thepresent invention.

In still furtherance of the exemplary method, one of a plurality ofhoses or hose attachments is selected, wherein the plurality of hosesfrom which the selection can occur includes at least one hose having afirst end, a second end and a single lumen defined there between, aswell as at least one hose having a first end, a second end and more thanone lumen defined there between. The first end of the selected hose isthen connected to said second adapter and the second end of the selectedhose is connected to at least a first piece of equipment to enable ablood pressure measurement to be performed, wherein this first piece ofequipment can be any manual or electronic blood pressure measurementdevice.

This exemplary method enables blood pressure measurements to beinterchangeably performed using one or more similar or different bloodpressure measurement devices. These measurements can occur, for example,without removing the selected hose that has been attached to the secondadapter, such as by disconnecting the second end of the selected hosefrom the first piece of equipment and connecting the second end of thesecond hose to a second piece of equipment that is similar or differentfrom the first piece of blood pressure measurement equipment so as toenable a similar or different blood pressure measurement to beperformed. Alternatively, these measurements also can occur throughremoval of the first selected hose that had been attached to the secondadapter, such as by disconnecting the second end of the first selectedhose from the first piece of blood pressure measurement equipment andthen disconnecting the first end of the first selected hose from thesecond adapter. Thereafter, another of the plurality of hoses isselected and its first end is connected to the second adapter and itssecond end of said plurality of hoses to a second piece of equipment toenable a separate blood pressure measurement to be performed.

In accordance with another exemplary aspect of the present invention, akit can be provided that includes or is adapted to include variousequipment to enable interchangeable measurement of a patient's bloodpressure in a variety of ways and/or through use of a variety of bloodpressure measurement equipment or devices. The kit generally willinclude at least one cuff that is adapted to be wrapped about a limb ofa patient, wherein each cuff includes an interior chamber and anexterior surface. The various features of the cuff are generally similaror identical to those described above with respect to the exemplarysystem of the present invention. The kit generally also will include afirst adapter that is substantially disposed within the exterior surfaceof the cuff, wherein the first adapter includes an opening that extendsinto the interior chamber of the cuff to provide direct fluidcommunication between the exterior surface and the interior chamber ofthe cuff. The various other features of the first adapter also aregenerally similar or identical to those described above with respect tothe exemplary system of the present invention.

The exemplary kit generally also will include at least one (and,optionally, a plurality) of additional adapters, each of which isadapted for connection (e.g., individual, releasable connection) to thefirst adapter in order to provide direct fluid communication between thefirst adapter and the at least one additional adapter. The exemplary kitgenerally will include, as well, a plurality of hoses or hoseattachments, each of which has a first end and a second end. The firstend of each of said plurality of hoses is adapted for individualconnection to one, some or all of the at least one additional adapter,via one or more barbs protruding from or one or more recesses definedwithin each of the at least one additional adapter. The second end ofeach of said plurality of hoses is adapted for individual connection toone, some or all of at least one piece of equipment in order to enable ablood pressure measurement to be performed. As described above withrespect to the exemplary system of the present invention, each of theplurality of hoses can have a single lumen or more than one lumendefined therein. Optionally, if the hose has two lumens defined therein,one or more of the additional adapters can include a first chamber, asecond chamber and a dividing zone as discussed above with respect tothe exemplary system of the present invention.

Still other aspects, embodiments and advantages of the present inventionare discussed in detail below.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a side elevation view, shown in section, of a pressuremeasuring device according to the present invention;

FIG. 2 is an enlarged sectional view of the pressure measuring device ofFIG. 1, depicting alternate means for attaching a rotatable dial face inrelation to the device;

FIG. 3 is a side elevation view, shown partly in section, of a pressuremeasuring device having a housing according to a second preferredembodiment;

FIG. 4 is a side elevation view, shown partly in section, of a pressuremeasuring device having a housing according to a third preferredembodiment;

FIG. 5 is a partial sectional view of a pressure measuring device madein accordance with a fourth preferred embodiment as used with aninflatable blood pressure sleeve;

FIG. 6 is a side elevation view, partly in section, of a pressuremeasuring device made in accordance with a fifth preferred embodiment ofthe present invention;

FIG. 7 is an unassembled view of the pressure measuring device of FIG.6;

FIG. 8 is a partially exploded view of the housing of the pressuremeasuring device of FIGS. 6 and 7;

FIG. 9 is a side elevation view, in section, of a gage housing made inaccordance with a sixth embodiment of the present invention;

FIG. 9A is an enlarged view of the attachment of the peripheral bumperto the gage housing of FIG. 9;

FIG. 10 is a top perspective view of the gage housing of FIG. 9;

FIG. 11 is a side perspective view of a gage housing made in accordancewith a seventh embodiment of the present invention;

FIG. 12 is a side elevation view, in section, of the gage housing ofFIG. 11;

FIGS. 12A and 12B are enlarged partial sectioned views of a protectiveperipheral bumper as attached to the gage housing of FIG. 12;

FIG. 13 is a top perspective view of the gage housing of FIG. 12;

FIG. 14 is a bottom perspective view of the gage housing of FIG. 12having a shock resistant feature made in accordance with anotherembodiment of the present invention;

FIG. 15 is a partially exploded view of a conventional blood pressuremeasuring apparatus;

FIGS. 16 and 17 are side elevation views, partly in section, ofconventional gage housings which have been configured for directattachment to an inflatable blood pressure sleeve;

FIG. 18 is a top view of a blood pressure measuring apparatus inaccordance with a preferred embodiment of the invention;

FIG. 19 is a perspective view of the inflatable sleeve of the apparatusof FIG. 18 as used with a patient;

FIG. 20 is an assembled top perspective view of a blood pressuremeasuring apparatus in accordance with another preferred embodiment ofthe present invention;

FIG. 21 is the top perspective view of the blood pressure measuringapparatus depicted in FIG. 20 with the electronic gage module removedfrom the sleeve;

FIG. 22 is a functional block diagram of a capacitance transducer foruse in the electronic gage module of the blood pressure measuringapparatus of FIGS. 20 and 21;

FIG. 23 is a cross sectional view of a capacitance sensor assembly usedthat can be used in the electronic gage module of FIGS. 20-22;

FIG. 24 is a preferred oscillator circuit for use in the electronic gagemodule of FIGS. 20-23;

FIG. 25 is a cross-sectional view illustrating the interior of anotherelectronic gage housing in accordance with the present invention;

FIG. 26 is a functional block diagram of another configuration for usein the electronic gage module of FIGS. 20-25;

FIGS. 27 and 28 depict bottom and top perspective views, respectively,of another electronic gage module in accordance with the presentinvention;

FIG. 29 is a top view of a cuff with an attached first adapter inaccordance with an exemplary embodiment of the present invention;

FIGS. 30A and 30B are perspective and bottom views of a first exemplaryembodiment of a second adapter in accordance with the present invention;

FIG. 30C is a front view, with cut away of a first adapter releasablyconnected to the second adapter of FIGS. 30A and 30B;

FIG. 30(D) is an enlarged portion of FIG. 30(C).

FIGS. 31A and 31B are perspective and bottom views of a second exemplaryembodiment of a second adapter in accordance with the present invention;

FIG. 32 is a side view, with cut away of a first adapter releasablyconnected to the second adapter of FIGS. 31A and 31B;

FIG. 33 is an exploded view of the components of a blood pressuremeasurement system in accordance with an exemplary embodiment of thepresent invention;

FIG. 34 is an exploded view of the components of a blood pressuremeasurement system in accordance with an alternative exemplaryembodiment of the present invention; and

FIG. 35 is a top view of various exemplary configurations of an attachedhose in accordance with the present invention.

DETAILED DESCRIPTION

The present invention is herein described with reference to severalpreferred embodiments, each of which specifically relates to bloodpressure measuring apparatus. However, it should be evident to one ofsufficient skill in the field that certain other variations andmodifications could be made utilizing the inventive concepts describedherein, as well as alternate applications other than blood pressuremeasurement, including use in barometers, pressure vessel indicators,pressure sensitive switches, valves, and literally any industrial ormedical device requiring a pressure responsive element. Furthermore andthroughout the course of the following discussion, terms such as“upwardly,” “downwardly,” “upper,” “lower,” “top,” “bottom,”“vertically,” “horizontally,” and the like are used to provide a frameof reference with regard to the accompanying drawings. These terms,however, should not be treated as limiting with regard to the inventionas described herein.

In addition, a number of terms are used herein which requiredefinitions. “Gearless” as used herein refers to any movement mechanismdisposed within a gage housing which does not include a gear orgear-like element. “Hoseless” as used herein refers to a directconnection between a gage housing and an inflatable sleeve of a pressuremeasuring apparatus without any intermediate hose or hoses therebetween. Several preferred embodiments of hoseless attachments for ablood pressure measuring apparatus are described throughout the courseof the following discussion. “Connected” as used herein refers to stateof being reversibly (e.g. releasably) or irreversibly joined in directcontact.

Referring to FIG. 1, there is shown a blood pressure measuring device orapparatus 10 made in accordance with a first embodiment of theinvention. The device 10 includes a substantially cylindrical gagehousing 12 having an interior cavity 14 defined by a circumferentialinner wall 16, an open top end 18, and a bottom end 20. A viewing windowor bubble 22, made from glass, plastic, or other suitable transparentmaterial is attached in a known manner to the open top end 18 of thegage housing 12. The bottom end 20 of the gage housing 12 has a diameterwhich inwardly tapers down to a narrow downwardly extending portion 24having a bottom opening 26 serving as an inlet port for admitting afluid. Preferably, the diameter of the narrow extending portion 24 isabout one third of the diameter of the major portion of the housing 12,though it will be apparent from the following discussion that thisparameter can be suitably varied depending upon the application.

The interior cavity 14 of the housing 12 is sized for retaining a numberof component parts, including a horizontally disposed support plate 28.The support plate 28 is a generally planar member having opposing topand bottom facing sides 30, 32, and a central through opening 34. Apress-fitted or otherwise suitably attached or integral sleeve 36attached to the top facing side 30 of the support plate 28 extends intothe central through opening 34 of the support plate 28 and is used forretaining a movement mechanism 40, described in greater detail below.

The circumferential inner wall 16 of the housing 12 further includes areflexed portion 19 which is sized for supporting an outer edge 21 ofthe horizontal support plate 28 immediately there beneath and at apredetermined height within the housing 12. The central through opening34 is shown as being substantially aligned with the bottom opening 26 ofthe housing 12, but this particular alignment is not critical to theworkings of the present invention and therefore can be varied.

Referring to FIGS. 1 and 2, a diaphragm subassembly 42 includes aflexible diaphragm 44 which is non-fixedly attached to the bottom facingside 32 of the horizontal support plate 28. The diaphragm 44 issubstantially horizontally planar and includes a plurality of wave-likesurfaces 49. An outer edge 47 of the diaphragm 44 is clamped by anO-ring 46 disposed on a circumferential ledge 45 extending upwardly fromthe bottom end 20 of the housing 12. The O-ring 46 not only supports thediaphragm 44 in place, but also provides a fluid tight seal for thebottom of the interior cavity 14.

The centermost portion of the substantially horizontally planardiaphragm 44 includes a downwardly extending section, herein afterreferred to as the pan 48, which is soldered or otherwise fixed or evenintegral with the remainder of the diaphragm 44. The pan 48 is a hollowcylindrical section which extends into the downwardly extending portion24 of the housing 12 when assembled and includes a cavity 50 having awidth dimension that is substantially equal to that of the press-fittedsleeve 36. A lower end 53 of the pan 48 includes a interior contactsurface 52 that is hardened.

Referring specifically to FIG. 1, the movement mechanism 40 includes anaxially displaceable shaft member 54 that is wholly enclosed within ahollow tubular member 56 with the exception of protruding top and bottomends 57, 55, respectively. A thin flexible ribbon-like spring member 70is fixedly attached at one end 61 adjacent a bottom end of the tubularmember 56 to a fixed portion of the tubular member and at an oppositeremaining end 59 to the axially displaceable shaft member 54 aroundwhich the ribbon spring member 70 is helically or spirally wound. Thehollow tubular member 56 includes a set of external threads 73 extendingover an upper portion of the length thereof that engage correspondinginternal threads 75 provided in the press-fitted sleeve 36. The ribbonspring member 70 is preferably fabricated from beryllium copper, springsteel, or other similar material.

The hollow tubular member 56 includes an integral top cap portion 58having a diameter which is larger than that of the remainder of themember, the cap portion having a shoulder which bears against a biasingspring 68 disposed within an annular recess 69 of the press-fittedsleeve 36. The top cap portion 58 and the biasing spring 68 are used toadjust the overall sensitivity of the movement mechanism 40.

When correctly positioned, the majority of the movement mechanism 40extends beneath the horizontal support plate 28 and into the cavity 50defined in the pan 48 which is already positioned in the downwardlyextending portion 24 of the housing 12. In this position, the extendingbottom end 55 of the shaft member 54 is proximate to the hardenedcontact surface 52.

Still referring to FIG. 1, a dial face 63 having measuring indicia (notshown) is attached to the top facing side 30 of the horizontal supportplate 28 through a center opening which is sized to fit over thepress-fitted sleeve 36. An O-ring 65 disposed in a slot 67 of thetubular sleeve 36 engages an inner edge of the dial face 63 with anindicating member 62 being mounted to the protruding top end 57 of theshaft member 54. A preferred lightweight indicating member useful in hisdesign is described in U.S. Pat. No. 6,644,123, the entire contents ofwhich are herein incorporated by reference.

In operation, changes in the pressure of incoming fluid (in thisexample, air) entering the bottom opening 26 of the housing 12 causecorresponding movements of the diaphragm 44. That is, the seal providedonto the outer edge 47 of the diaphragm 44 by the O-ring 46 clampingagainst the top face of the housing ridge 45 prevents air from furtherpenetrating into the interior cavity 14. Therefore, the increase inpressure causes axial movement of the diaphragm pan 48 with the interiorcontact surface 52 being caused to push upwardly against the bottom end55 of the axially displaceable shaft member 54. As a result of theupward movement of the diaphragm 44, the top end of the ribbon springmember 70 is caused to extend relative to the fixed bottom end 61 of thespring member which is fixedly attached to the bottom end of the tubularmember 56. This extension causes the shaft member 54 to rotate about itslinear axis. The 23 rotation of the axially displaceable shaft member 54therefore causes a corresponding circumferential movement of theindicating member 62 attached to the top end 57 of the shaft member 54relative to the measuring indicia (not shown) on the dial face 63.

Zero adjustment of the above pressure measuring device 10 is arelatively simple procedure, as compared with previously known devices.First, the viewing window 22 is removed from the open top end 18 of thegage housing 12. The engagement of the O-ring 65 against the inner edgeof the dial face 63 allows the dial face to be freely rotated inrelation to the position of the indicating member 62. Sensitivityadjustments can also be made at the top of the device 10 by rotating thetop cap portion 58 against the biasing spring 68 within the annularrecess 69 of the press-fitted sleeve 36, so as to adjust the sensitivityof the ribbon spring member 70 for a given rotation. A similar mechanismis described in previously incorporated U.S. Pat. No. 6,168,566.

Variations of the above device are possible. For example and referringto FIG. 2 and in lieu of an O-ring, either the dial face 63A and/or thehorizontal support plate 28A can be tapered suitably adjacent theircenter openings relative to a shoulder 80 provided on the tubular sleeve36A in order to allow the dial face to be rotated without requiringremoval. Alternately, the movement mechanism 40 can include a zeroadjustment feature as described in U.S. Pat. No. 5,966,829 and U.S. Pat.No. 6,168,566. In passing, it should be noted that FIG. 2 merelyillustrates a portion of the overall assembly in order to distinctlyfacilitate the above discussion.

A housing design in accordance with a second embodiment is illustratedin FIG. 3. Similar parts are herein labeled with the same referencenumerals for the sake of clarity. As in the preceding, the deviceincludes a gage housing 12 having an interior cavity 14 sized forretaining a diaphragm assembly 42 that includes a diaphragm 44 having aseries of wave-like surfaces 49, as well as a downwardly extendingportion or pan 48. The device further includes a substantiallyhorizontally disposed planar support plate 28, the housing 12 furtherhaving a downwardly extending narrowed portion 24. A movement mechanism40 is disposed through a central opening 34 defined in the horizontalsupport plate 28 such that the bottom end 55 of an axially displaceableshaft 54 of the mechanism is disposed in proximity to a hardened contactsurface 52 of the pan 48 of the diaphragm assembly 42. The diaphragm 44in the meantime is attached, but not sealed, to the bottom facing side32 of the horizontal support plate 28.

A fluid, such as air, entering the gage housing 12 through a bottomopening 26 causes deflection of the pan 48 of the diaphragm 44 againstthe axially displaceable shaft 54, thereby causing rotation of the shaftby means of an attached ribbon spring member 70, according to the mannerpreviously described.

According to this particular embodiment, the device includes a dockinghub 82 that is provided on the exterior of narrow downwardly extendingportion 24 of the housing 12, the hub including a circumferential groove114 which is sized for retaining an O-ring 118 or other similar sealingelement. For example, the docking hub 82 can utilize pipe or other formof known threads (not shown). The docking hub 82 provides adequatemodification to allow the device to be attached to other existingpressure device housings having pressure sources, for example, thosemanufactured by Welch Allyn, Inc. of Skaneateles Falls, N.Y., amongothers. In passing, it should be noted that the position of the bottomopening 26 of the housing 12 is not essential; that is, incoming fluidcan enter the housing 12 from either a horizontally or otherwisedisposed port, so long as the opening is beneath the seal that isprovided by the O-ring 118.

To further illustrate variations and referring to FIG. 4, a thirdembodiment of a housing 12B made in accordance with the presentinvention includes a diaphragm 44B, which unlike the precedingembodiments, is a substantially vertical member having an overall widthdimension that is considerably narrower than those previously described.As a result, a horizontal support plate is not required, as in thepreceding.

As in the preceding embodiments, an outer edge 47B of the diaphragm 44Bis sealed using an O-ring 46B or other sealing member which effectivelyclamps the outer edge to a shoulder of the a press-fitted sleeve 36B.The movement mechanism 40 is disposed essentially through a centeropening in a press-fitted sleeve 36B and threaded into engagementtherewith. The majority of the movement mechanism 40 is disposed withinthe cavity defined by the essentially vertical diaphragm 44B, theparticular diaphragm of this embodiment having vertically disposedwave-like surfaces 49B. Adjustments to control the sensitivity of themovement mechanism 40 using biasing spring 68B are performed in themanner previously described.

Overall, the housing of the instant embodiment defines a very shallowprofile for the upper portion of the gage housing 12B. Though not shown,the bottom end 20B of the gage housing 12B can be used as a docking hubto secure the gage housing into other gage housings (not shown) eitheras a retrofitted or as a new assembly as previously described. Asfurther described herein, this docking hub can also permit directhose-free connection between a gage housing and an inflatable bloodpressure sleeve.

Referring to FIG. 5, a gage or instrument housing 140 formed inaccordance with a fourth embodiment of the present invention is hereindescribed in combination with a blood pressure sleeve or cuff 142. Forpurposes of the present embodiment, the instrument housing 140 is usedwith a specific blood pressure cuff that is described in greater detailin U.S. Pat. No. 6,036,718, the contents of which are herebyincorporated in its entirety. In brief, the inflatable cuff 142 ismanufactured using a pair of sleeve portions 144, 146 that are sealedtogether using a series of continuous RF (radio frequency) welds to forman integral bladderless structure having an inflatable inner volume 148.In operation, the cuff 142 is then wrapped as conventionally known aboutthe arm 170 (partially shown) or other limb of a patient.

The gage housing 140 includes an upper housing portion 152, a lowerhousing portion 154, and a connecting intermediate portion 156. Theupper and lower housing portions 152, 154 are substantially cylindricalin cross section and have approximately the same dimensions while theintermediate portion 156 has a substantially smaller diameter that isconsiderably narrower than either adjoining section, thereby defining aconfiguration resembling a yo-yo. According to the present embodiment,the intermediate portion 156 has a diameter which is approximately onethird the diameter of the remaining portions 152, 154, but it will bereadily apparent that this parameter can be varied depending on therelative size of the movement mechanism used therein. Each of the aboveportions 152, 154, 156 are interconnected and hollow, combining to forman interior cavity

According to this embodiment, a horizontal support plate 165 (shown mphantom), is positioned within the lower portion 154 of the housing 140while a dial face 167 (also shown in phantom) is disposed in the upperportion 152. A movement mechanism 171 (also shown in phantom), which issimilar structurally to those previously described, interconnects thedial face 167 and the support plate 165 and is located primarily in theintermediate portion 156.

According to this embodiment, a button-hole like slot 162 is cut both ofthe inner and outer sleeve portions 144, 146. The edges of the slot 162are sealed. The above slot 162 provides a button-like retainment for thelower portion 154 of the housing 140 as well as the intermediate portion156, with the upper portion 152 protruding from the exterior of the cuff142. A port 176 is connected via a hose 178 to the inflatable innervolume 148 of the cuff 142 which is inflated by a pneumatic bulb (notshown) in a well known manner.

In operation, the device operates similarly to that previouslydescribed, except that a detachable stethoscope adapter 166 can also beattached to the bottom of the lower housing portion 154, thereby formingan integral unit. The bottom of the lower portion 154, according to thisembodiment, includes an extending attachment portion 174 sized to engagea female connector 180 or other suitable means provided on the adapter166. All preceding known cuffs require separation between the cuff andthe stethoscope. With the overall shallow profile of the above housing140, use of an adapter 166 permits an interconnection which is highlyadvantageous.

The stethoscope adapter 166 is a conical member which forms the bell ofthe stethoscope having connecting ear pieces (not shown) attached to aport 184. In use, the adapter 166 is freely rotatable relative to thehousing 140, allowing examination by a patient or care giver to beperformed equally well. The overall workings of stethoscopes arecommonly known and do not form part of the inventive concepts describedhereon.

Referring to FIGS. 6-8, there is shown a blood pressure measuring devicemade in accordance with a fifth embodiment of the present invention. Asin the preceding, similar parts are labeled with the same referencenumerals for the sake of clarity. This device includes an RF-weldedblood pressure sleeve 142 similar to that described in the previouslyincorporated '718 patent including a pair of sleeve portions 144, 146which are sealed together to form an integral structure and define aninflatable inner volume 148. The sleeve 142 is sized to be wrappedaround the arm or other limb of a patient (not shown) in a manner whichis commonly known, and therefore requiring no further explanation. Asocket 190 is disposed and fixed within an opening that is provided onthe exterior of one of the sleeve portions 144, the socket being sizedto receive a mating portion of an instrument or gage housing 194. Theinstrument housing 194 according to this embodiment is similar to thosepreviously described including a narrowed bottom portion, but in whichthe bottom portion also includes a ball-shaped engagement or mating end196. When assembled, the ball-shaped engagement end 196 is fitted withinthe socket 190 of the sleeve in order to provide a direct fluid andsealed connection therewith, the gage housing 194 being free to pivotrelative to the plane of the sleeve 142, about the socket 190, as shownby reference numeral 198.

The engagement end 196 includes an opening 200 that permits fluidcommunication with the interior of the sleeve 142 wherein fluid (e.g.,air) can enter the interior of the gage housing 194, causingcorresponding movement of a diaphragm and a contained movement mechanism(not shown in this view), in the manner previously described herein.

Preferably, the vlewmg window 22 of the housing 194 includes ananti-reflective coating to reduce or substantially reduce glare, withthe user (physician or care giver) or patient having the ability toeither rotate the housing or to pivot same in order to effectivelyutilize the instrument and read the dial face. As such, the gage housing194 can effectively be used in either a right or left-armed patientmeasurement. A sleeve that further provides this ability with anattached gage housing is described in greater detail below.

Still referring to FIGS. 6-8, the device further includes a rubberizedring-shaped guard or bumper 202 that is press-fitted into engagementabout the outer periphery of the gage housing 194, the bumper having aridge 206 extending a predetermined distance above the viewing window22. The bumper 202 performs at least two functions; first, and thoughthe present device is ultra-lightweight, the bumper additionally absorbsshock or impact loads when the housing 194 is dropped. Second, thebumper 202 also reduces the likelihood of damage to the viewing window22.

As described in greater detail in a succeeding embodiment, it should benoted herein that the mating or engagement end of the narrowed bottomportion of the instrument or gage housing need not include a “ballshape”for accommodation within the sleeve socket 190. Examples are discussedbelow with reference to FIGS. 9-14.

Furthermore, it should also be apparent that literally any gage housingsthat include a pressure responsive member can be configured orretrofitted for direct engagement with a blood pressure sleeve withoutrequiring hoses (hoseless) between the housing and the sleeve. Moreover,these housings should not be limited merely to mechanically based gagehousings, as described in the foregoing, in that electronic versions canalso be retrofitted to the above described sleeve if the electronicversion includes or is adapted to include a suitable mating orengagement end.

One example of a prior art mechanical system is partially shown in FIG.15, and is defined by a gage housing 296 that retains a conventionalmovement mechanism 292. The movement mechanism 292 includes a threadedend 297 extending through a bottom opening 299 of the gage housing 296and is received into the mating threaded end of a port 300 of a tubularmember 305, the input end of which includes a pneumatic bulb 307. Inuse, the output end 309 of the tubular member 305 receives a hose (notshown) that extends to a coupling of a blood pressure sleeve (notshown).

Referring to FIGS. 16 and 17, respectively, a pair of known mechanicalgage housings 294, 306 are shown that can be interconnected to a bloodpressure sleeve 324 in a manner similar that previously described. Eachof these conventional housings 294, 306, similar to those of FIG. 15,are less compact than those which have been expressly detailed, mainlybecause of the intricacy and sizing of the movement mechanism that iscontained therein. Each of the gage housings 294, 306, however, docommonly contain a threaded engagement end or inlet port 298, 310, thatpermits fluid communication between the housing interior and thepneumatic bulb 307, FIG. 15. The pneumatic bulb 307 is attached using ahose (not shown) to the inlet port. As noted previously, any gagehousing having an engagement or inlet end and including literally anyform of movement mechanism can be reconfigured according to the presentinvention for hoseless interconnection with an inflatable sleeve. Anumber of additional examples are now described to further illustratethis point.

According to the present invention and in order to retrofit the gagehousings 294, 306, the end of the threaded inlet port 298, 310 can becovered with an adapter or cap 302 which is sized for sealing engagementwithin a socket 320 provided in an inflatable blood pressure sleeve 324.The cap 302 and the socket 320 each include respective openings 304,308, which as shown in FIGS. 16 and 17 upon attachment to the inflatablesleeve 324, permits direct fluid communication between the interior 328of the sleeve 324 and the interior of the housing 294, 306, the housingbeing preferably snap-fitted to the sleeve. As a result, there is noneed to include the hoses which are essential to the prior art assemblyof FIG. 15, thereby greatly simplifying the use of even conventionaldevices by permitting direct, hose free connection to an inflatableblood pressure sleeve.

Referring to FIGS. 20-28, another series of preferred embodiments areherein described to better depict the versatility achieved by thepresent invention. All of the preceding embodiments have referred toso-called mechanical hoseless connections, that is, each of the gagehousings have included a movement mechanism which is mechanical innature. As noted above, however, any form of movement mechanism that iscapable of producing a result based on a change of pressure can beutilized.

To that end and first referring to FIGS. 20 and 21, a blood pressuremeasuring assembly 400 includes a blood pressure sleeve 404 such aspreviously described which is bladderless, such as described in U.S.Pat. No. 6,036,718, the sleeve including a port 408 containing a smallopening 412 that maintains fluid communication with the interior (notshown) of the sleeve. The port 408 permits engagement to an electronicgage module or housing 420 having a number of interior component parts,that are described in greater detail below, as well as a proximal end424 that is sized to permit a direct releasable connection with the portwithout the need or requirement of additional hoses there between, theproximal end including an aligned end opening 428. The sleeve 404 isinflated by means of a pneumatic bulb 434 that is tethered by a hose 438 to a coupling 442 provided on the sleeve, the coupling having anopening extending into the interior of the sleeve. A bleed valve 446adjacent the pneumatic bulb 434 assists in the deflation of the sleeve404 in a manner conventionally known. The sleeve 404 is bladderless, canbe securably wrapped about a limb of a patient (not shown) by means ofhoop and loop fastener portions 445.

Referring to FIG. 22, a block diagram illustrates the primarycomponentry, in this instance, a capacitance transducer assembly 450 ofan electronic pressure gauge contained within the electronic gage module420. This transducer assembly 450 generally includes a capacitancepressure sensor transducer 454 that is responsive to a stimulus, (inthis instance, the stimulus is the input of fluid into the interior ofthe electronic gage module from the sleeve 404, FIG. 20), the transducerbeing operatively connected to an oscillator circuit 458. A measurementand processing circuit 462 is connected to the output of the oscillatorcircuit 458. The measurement and processing circuit 462 includes acounter circuit 466 that is connected to a data processor 4 70, each ofthe latter being connected to a reference oscillator 474, the dataprocessor being connected to user I/O devices 475. In this instance, theI/O devices 475 include an actuable button 476, FIG. 20, provided on theexterior of the module as well as a display 478, FIG. 21.

In terms of general operation, essentially the dynamic portion oftransducer 454 is a variable capacitor. As the measured environmentalparameter changes (the entering fluid pressure), the capacitancechanges. The oscillator circuit 458 converts this capacitance changeinto an AC signal. The processor 470 converts the measured frequencyinto the parameter (e.g., pressure) measurement and the measuredparameter is then displayed upon the display 478.

Referring to FIG. 23, a preferred capacitance sensor transducer 454 foruse in the above assembly 450 is described in greater detail forexemplary purposes, the transducer including a capacitance sensor thatincludes a metallic conductor layer 480 formed on a surface of a circuitboard 484. A ground conductor layer 488 is disposed on the oppositesurface 492 of the circuit board 484, that also includes a dielectricmaterial, disposed between the conductor layer 480 and the groundconducting layer 488. A metal ring 496 is connected to the circuit board484 by pins 500, that are inserted through a ring conductor 504. Themetal ring 496 receives structural support from a support plate 508 thatis disposed between the circuit board 484 and the metal ring 496. Thesupport plate 508 causes the conductor layer 480 and the support planeof the metal ring 496 to be coplanar, thereby reducing mechanicaltolerance stack-up. A metallic diaphragm 512 is coupled to the circuitboard 484 as sandwiched between the metal ring 496 and an O-ring 516.Therefore, the metallic diaphragm 512 is disposed over the circuit board484 and is juxtaposed relative to the conductor layer 480 to form avariable capacitor. The metallic diaphragm 512 is held in place by theO-ring 516 which is pressed against the diaphragm and metal ring 496 bya snap-on cap 520. The snap-on cap 520 includes a port 522 aligned topermit fluid to enter same as stimulus as well as multiple snaps 524that fit over the edge of the metal ring 496. A set of electronics; moreparticularly, an oscillator circuit 458 and a measurement and processorcircuit 462 as well as a reference oscillator 474, for the sensor aremounted to the underside 492 of the circuit board 484.

Referring to FIG. 24, a schematic of a preferred oscillator circuit isherein described. This circuit 458 includes a first loop having aninverter gate 530, inverter gate 534, resistor 538, and a capacitivesensor 540, such as just described in FIG. 23, in series. An optionalcapacitor 542 is connected between the input of the inverter gate 530and ground. An optional capacitor 544 is connected between the output ofthe resistor 538 and ground. The capacitor 542 and capacitor 544 are inparallel with stray capacitances resulting from the construction of thesensor 450 and the proximity of the oscillator 458 on the circuit board492 to the ground conductor. A low-pass filter 548 is formed by theseries resistor 538 in combination with the capacitor 542, capacitor 544and the stray capacitances referred to above. The oscillator circuit 458also includes a second loop in parallel with the resistor 538 andcapacitance transducer 540. The second loop includes an inverter gate552 in series with a resistor 556. The output of the oscillator circuit458 is connected to the measurement and processing circuit 462.

This oscillator circuit 458 is a type of RC relaxation oscillatorwherein the dynamic portion of the oscillator circuit 458 is thecapacitance transducer 540, as described above. Additional detailsconcerning the above sensor and transducer assembly, including the abovereferred to oscillator circuit, can be found in U.S. Pat. No. 6,828,801,the entire contents of which are herein incorporated by reference.

A cross-sectional view of the components as stored within the interiorof another version of another suitable electronic gage module 560 areshown in FIG. 25. It should be readily apparent that this module isexemplary, and that modifications and variations can be found, forexample, in U.S. Pat. Nos. 5,323,782 and 5,316,006. Exterior views ofthis module 560 are depicted in FIGS. 27 and 28, the module having anovate geometry that is defined by a housing body 564 which includes aupper or major housing section 566 and a proximal engagement section 568that is sized to be sealingly and releasably fitted into a port orsocket 408 of a blood pressure sleeve 404, such as that shown in FIGS.20 and 21, and in the manner previously described. The proximalengagement section 568 includes an end opening 572 extending into theinterior of the module 560 and particularly to a contained capacitancetransducer sensor assembly 582, coupled to a circuit board 586, thesensor assembly having a metallic diaphragm (not shown in this view) andoperative in a manner as previously described. The interior of themodule 560 further includes relevant circuitry as well as a processor594 interconnecting the above components including a display, such as anLCD 584 that positioned relative to a viewing window 588. Each of theabove are interconnected in the manner previously described to an inputmeans such as an ON/OFF button 598, disposed on the upper housingsection 566 of the module 560, each being powered by batteries 600.

The exterior of the housing body 564 further includes a peripheralbumper 576, shown in FIGS. 27 and 28 only, that protects the upperhousing section 566 when dropped. The bumper 576 is preferably raisedabove the LCD 584. Within the module 560 are a number of componentsincluding the capacitance transducer sensor assembly 582, similar tothat previously described,

Referring to FIG. 26, an alternate design for an electronic gage housingor module 640 is depicted wherein fluid enters a housing body 644 asfrom a sleeve (not shown) regulated by a valve 648 or pneumatic bulb(not shown) attached to a pressure-sensitive switch 652. The sensor 656,such as the preceding capacitive sensor is operatively connected toreceive the fluid incoming stream through a port 660, the sensor beingcontrolled by circuitry retained with a miniature processor 666. Bloodpressure readings are then calculated by the processor 666 for eitheroutput by a display 670 or the pressure information signal isalternately converted through appropriate means into digital values thatcan be transmitted wirelessly by means of a RF or IR based link 674 to aremote site (not shown).

In passing, it should further be noted that though an RF welded orbonded inflatable sleeve is described throughout, other forms ofinflatable sleeves can be utilized embodying the central concepts of thepresent invention, including both bladderless sleeves and sleeves havingbladders. In addition, other forms of systems can be employed other thanthe capacitance sensor described herein. For example, a strain gageincluding a silicon pressure sensor could be employed in combinationwith an analog amplifier and an AID converter to produce a digitalsignal. Alternately, a diaphragm could be employed in combination with apair of ultrasonic transducers to produce a time delay signal. Accordingto yet another example, an optical version could be contemplated using alaser and a diffraction grating in which interference fringe countscould be used as a determining means.

Still according to another alternative, a magnetic based system could beutilized in combination with a diaphragm and an L VDT. A MEMs-basedversion is also possible within the ambits of the invention provided thepackaging is suitably convenient for sleeve attachment. Each of theforegoing can be used with a diaphragm though use of a diaphragm mayalso not be required. For example, a Bourdon tube could be employed inlieu of a diaphragm. Alternately, a spring and a rolling seal pistoncould be substituted for the diaphragm, indicating the myriad ofpotential uses and applications.

Referring to FIGS. 9-11, there is shown a gage or instrument housing 210according to a sixth embodiment of the present invention. As in thepreceding, the gage housing 210 is used in connection with a bloodpressure measuring device and includes an upper housing portion 212which retains a movement mechanism 214 and a narrowed lower portion 218having a mating or engagement end 220 which is sized to engage agenerally cylindrical socket 222 formed in a sleeve portion of abladderless blood pressure cuff or sleeve 226. Unlike the precedingembodiment, the mating end 220 of the narrowed lower portion 218 is alsogenerally cylindrical in cross section, the end similarly including anend opening 224, shown in FIG. 11, which permits fluid communicationwith the interior of the blood pressure cuff 226 via a correspondingopening 228 also formed in the socket 222, thereby forming a fluid inletport.

The upper housing portion 212 of the gage housing 210 and the containedmovement mechanism 214 are similar to those previously described. Thatis, the movement mechanism 214 includes a helically wound thin ribbonspring 240 which is attached at one end to an axially displaceable shaftmember and at a second end to a tubular sleeve member in the mannerdescribed above. Changes in pressure of the cuff 226 cause fluid toenter the narrowed lower housing portion 218 through the end opening224, affecting a contained diaphragm 246 and causing the axiallydisplaceable shaft member to be translated upwardly, resulting inrotation of the shall member against the biasing of the ribbon spring240 and circumferential movement of an indicating member 248, attachedto a protruding top end of the shaft member, relative to a dial face.

The mating end 220 of the narrowed lower housing portion 218 can includea circumferential channel or notch 250, that is most clearly shown inFIG. 11. The circumferential channel 250 provides a discontinuous pathfor shock and impact loads and, therefore, effectively cushions thecontents of the gage housing 210 including the movement mechanism 214,from shock or impact loads such as when the housing 210 lands on thenarrowed lower portion 218.

According to this embodiment and as most clearly shown in FIGS. 9 and10, and to further insulate the housing 210 from damage due to shock orimpact loading, a rubberized peripheral guard or bumper member 232,sized to fit over the exterior periphery of the upper housing portion212 is press fitted into engagement therewith. The guard member 232 issimilar to that previously described above in that the entire peripheryof the upper housing portion 212 is covered, the guard member includinga stepped portion 234, shown in FIG. 9A, which extends over the top ofthe upper housing portion, including the viewing window, and defines anair gap 236 along the outer circumferential edge thereof. The air gap236 provides a discontinuous path for any inlpact loads which can occurif the gage housing 210 lands awkwardly.

Variations of the above embodiment of FIGS. 9-11 are possible. Forexample, and referring to FIGS. 12-14, there is shown a gage housing 260according to a seventh embodiment of the present invention. The gagehousing 260 also includes an upper housing portion 264 and a narrowedlower housing portion 268 having an engagement end 270 which mates witha socket 222 which is formed in blood pressure sleeve 226. The upperhousing portion 264 according to this embodiment is defined by asubstantially elliptical cylindrical cross section as opposed to thepreceding embodiments in which the upper housing portions aresubstantially circular cylinders. It should be noted that other shapesor geometries could be contemplated. According to this embodiment, acircular face groove 272 provided in the bottom surface 276 of theengagement end 270 provides a similar function to the circumferentialchannel 250, FIG. 11, with regard to shock or impact loads applied tothe housing if dropped or otherwise acted upon.

Otherwise, the engagement end 270 similarly engages the socket 222 ofthe sleeve 226, the gage housing 260 retaining a movement mechanism (notshown) as previously described. The engagement end 270 includes an endopening 271 which permits hoseless fluid communication with the sleeve226, also as previously described, through a socket opening 228 whichextends to the sleeve interior.

According to the instant embodiment, a rubberized guard member 280 ispress fitted over the exterior periphery of the upper housing portion264, the guard member according to this embodiment including a radiallyextending portion 284 which when attached extends from the outer edge ofthe elliptically shaped upper housing portion 264 and similarly providesa cushioning air gap 286 which creates a discontinuity, in fact abuffer, which insulates the housing 260 from impact loads when thehousing is dropped. Similar air gaps 288 are provided above the viewingwindow as defined in an axially extending portion 290 to provideadditional protection against shock or impact loads.

As shown in FIG. 12B, an O-ring 289 is provided within the annular airgap 288. Additional shock resistance between adjoining portions of thehousing 264 and the interior wall surface of the guard member include anannular rubberized shim 285.

Referring to FIGS. 18 and 19, a sleeve 344 for a blood pressuremeasuring apparatus 340 is herein described.

The sleeve 344 itself is constructed from a pair of sleeve portions 368,372 made from a polyamide or other similar fluid impermeable materialwhich are RF welded or bonded together and define an interior chamber.The interior chamber of the sleeve 344 is inflated by means of apneumatic bulb 356 which is tethered by tubing 360 to a barb or port 352provided on a sleeve portion 368, the barb having an opening which is incommunication with the interior chamber of the sleeve. A check valve 364provided adjacent to the pneumatic bulb 356 permits depressurization ofthe interior chamber of the sleeve 344 when the valve is opened.

The sleeve 344 includes hook and loop fastener portions (only one ofwhich 376 being shown) on the outward facing sides of each of the sleeveportions 368, 372 at opposite ends of the sleeve, thereby permitting thesleeve to be formed into a cylindrical shape and secured when wrappedabout the limb of a patient 375, as shown in FIG. 19. Each hook and loopfastener portion 376 is also preferably RF welded to a sleeve portion368, 372. Specific features relating to the above noted features,including the manufacture of the herein described sleeve 344, aredescribed in U.S. Pat. No. 6,036,718, herein previously incorporated byreference in its entirety.

When properly attached, the facing side of the sleeve portion 372contacts the patient with the facing side of the sleeve portion 368being exposed. According to the present embodiment, each facing side hasa different color to assist in attaching same to the patient. Accordingto the present embodiment, the sleeve 344 is two-toned with the facingside of the sleeve portion 372 having a black colored finish and thefacing side of the exposed sleeve portion 368 having a lighter coloredfinish.

A socket or port (not shown) similar to those described above and shownfor example in FIGS. 9 and 12 is also provided in the sleeve portion368, the socket being sized for receiving a gage housing 348 which isreleasably snap-fitted in the manner previously described and defined.The gage housing 348, when attached, can be rotated about its verticalaxis, permitting easy visual access to either the care giver and/or thepatient.

The gage housing 348 according to this embodiment is identical to thatpreviously shown and described in FIG. 9, the housing containing abellows assembly as well as a gearless movement mechanism which operatesin the manner described above to permit circumferential movement of anindicating member relative to a dial face when pressure changes withinthe interior chamber of the sleeve 344 cause movement to a movablesurface of the bellows assembly. The gage housing 348 also preferablyincludes the shock/impact resistant features previously described.

An artery index marker 380 is provided adjacent the hook and loopfastener portion 376 on the facing side of the sleeve portion 368. Thismarker 380 is used to align the sleeve with the brachial artery of thepatient, the marker further including left and right limb indicatorswhich are provided on respective lateral sides of the sleeve 344. Whenthe sleeve 344 is wrapped over the arm of the patient 375, the marker isused to properly and circumferentially align the arm and the artery withthe limb indicator pointing directly at the artery. The rotatability ofthe gage housing 348 within the sleeve 344 permits the sleeve having theattached gage housing to be used when attached regardless oforientation.

According to the present invention, sets of indicia 384, 388 are alsoprovided on the facing side of the sleeve portion 368 designating thesize of sleeve being used; that is, whether the sleeve is an adult,child or neonatal cuff. An adult sleeve is shown in the presentembodiment. The gage housing 348 can be releasably attached in themanner described herein to any of the above noted sleeves, regardless ofsize. Moreover, the above sleeve can be used with any of the abovedescribed gage housings, including the electronic modules described inFIGS. 20-23.

FIGS. 29-35 depict additional exemplary embodiments of the presentinvention in which systems, methods and kits are provided forinterchangeably enabling blood pressure measurements to be performed ona patient through use of different manual or electronic blood pressuremeasurement equipment or devices, while allowing the same cuff/sleeve tobe continually worn by the patient. Because a patient can wear the samecuff/sleeve while blood pressure measurements are performed using a widevariety of blood pressure measurement equipment, the present need tofrequently detach a cuff/sleeve from a patient and then locate andreattach a new sleeve/cuff is beneficially obviated.

Referring initially to FIG. 29, a cuff 1000 having an exterior surface1010 is shown with an attached first adapter 1100. Though only partiallyshown in FIG. 29, the cuff 1000 can be similar or identical to any ofthe various cuffs/sleeves 226, 324 shown in FIGS. 9, 12, 16 and 17 inthat the cuff 1000 is defined by an interior chamber (see, e.g.,reference numeral 328 in FIG. 17). The interior chamber of the cuff 1000can be formed in various manners in accordance with the presentinvention. By way of non-limiting example, and as shown in FIG. 17, twoconnected sleeves or sleeve portions 368, 372 can be connected togethersuch that an interior chamber is defined between the two sleeves orsleeve portions. Alternatively, the cuff 1000 can be formed of a singlesleeve or sleeve portion, e.g., by connecting a first edge of the sleeveto a second end of the sleeve such that an interior chamber is definedbetween the connected edges.

The cuff 1000 can be designed to be used only on that patient (i.e., adisposable cuff) or to be reused on multiple patients (i.e., a durablecuff). Also, the cuff 1000 can be made any suitable patient size,including but not limited to pediatric and adult sizes useful forattachment to either the arm or the thigh of a patient, wherein suchsize generally is indicated by textual, pictorial, color, textual and/orpictorial indicia on the cuff, e.g., as shown in FIGS. 18, wherein suchindicia is exemplarily identified by reference numerals 384, 388. Otherrepresentative such indicia 1050 is shown on the exterior surface 1010of the cuff 1000 FIGS. 33 and 34, though it should be apparent thatother variations and modifications are possible as well.

As shown in FIGS. 29 and 33, the first adapter 1100 is connected to thecuff 1000. The first adapter 1100, as described in greater detail below,includes a main body 1105 having an opening 1110 defined therewithin toprovide direct fluid communication between the exterior surface 1010 andthe interior chamber of the cuff 1000. The cuff 1000 has an opening 1030(see, e.g., FIG. 33) defined therewithin, wherein the opening is sizedto accommodate the first adapter 1100 and provides direct fluidcommunication to the interior chamber of the cuff. Generally, the firstadapter 1100 is substantially irreversibly connected to the cuff 1000 atthe opening 1030, e.g., by welding (e.g., RF welding, ultrasonicwelding), bonding or sealing, although such connection can also bereversible as well without departing from the intended ambit of thepresent invention.

In accordance with an exemplary embodiment of the present invention, thefirst adapter 1100 can be a socket, which is disposed substantiallywithin the exterior surface 1010 of the cuff 1000, or, as depicted inFIGS. 29 and 33, a fitting, at least a portion of which protrudes fromthe exterior surface of the cuff by a predetermined distance.

In either instance, the main body 1105 of the first adapter 1100optionally can include a circumferential radial seal 1120 that is incommunication with the exterior surface 1010 of the cuff 1000, whereinthe radial seal, if present, has a diameter greater or smaller than thediameter of the first adapter opening depending on specific attachmentconditions. Also, the first adapter 1100 can include a circumferentialring 1130 and a ridge 1140. When present, the ring 1130 and ridge 1140collectively form a portion 1150 of the first adapter 1100 thatinterfaces with the second adapter 1200, wherein the ring extends fromthe main body 1105 and the ridge extends from the ridge, as best shownin FIGS. 30C and 32-34. The overlap of the circumferential radial seal1120 with specific portions of the second adapter 1200 as well as theridge 1140 with portions of the second adapter 1200 is intended to showthe position of the radial seal 1120 and the ridge 1140 when the secondadapter 1200 is not engaged with the first adapter 1100. The main body1105 of the first adapter 1100 can be made from the same material as theinterfacing portion 1150 of the first adapter, or, alternatively, can bemade of one or more different materials. Optionally, the main body 1105of the first adapter 1100 can include a flange (not shown) that extendsbeneath the main body to enable or facilitate connection of the firstadapter to the interior chamber of the cuff 1000.

The entire first adapter 1100 can be made of a single material, or, ifinstead desired, of more than one material. By way of non-limitingexample, the entire first adapter 1100 can be made of a flexible plasticmaterial or of a comparatively more rigid plastic material, wherein thespecific material choice can depend on various factors such as cost,durability and/or marketplace demands. Alternatively, the first adapter1100 can be made of two or more different materials, such as a first,flexible material and a second, comparatively more rigid (i.e., lessflexible) material. In accordance with an exemplary such alternativeembodiment, a portion of, or, as is currently preferred, the entirety ofthe main body 1105 (including, if present, the downwardly extendingflange) of the first adapter 1100 can be made of a flexible plasticmaterial, whereas one or more portions of the interfacing portion 1150of the first adapter (i.e., the ring 1130 and/or the ridge 1140) can bemade of one or more comparatively more rigid (i.e., less flexible)plastic materials. Exemplary flexible plastic materials from which hemain body 1105 can be made include, but are not limited to,thermoplastic polyurethane elastomeric materials such as pellethane,polyvinyl chloride and thermal plastic rubbers, and exemplary lessflexible materials from which the comparatively more rigid ring 1130and/or ridge 1140 can be made include, but are not limited to,polycarbonate materials, crylic materials, rigid vinyls andacrylonitrile butadiene styrene, or other rigid thermal plasticscompatible for bonding with the selected flexible plastic material.

This alternative design for the first adapter 1100 is advantageous inthat it provides the first adapter with dual flexibility—that is, themain body 1105 of the first adapter is flexible so as to facilitateconnection of the first adapter to the cuff 1000, whereas one or more ofthe other portions (e.g., one or more of the ring 1130 and/or the ridge1140) of the first adapter are comparatively more rigid (i.e., lessflexible) so as to reliably maintain the connection (described below)between the first adapter 1100 and the second adapter 1200. As such,this alternative design enables the first adapter 1100 to fulfill itsintended role—in the interchangeable blood pressure measurement systems,methods and kits described herein—with increased reliability and for acomparatively longer duration than if the first adapter was to be formedsolely of a single material.

The system of the present invention further includes a second adapter1200, described in greater detail below, which is releasably connectedto the first adapter 1100, and which can have various designs as shown,e.g., in the first exemplary embodiment of FIGS. 30A and 30B and thesecond exemplary embodiment of FIGS. 31A and 31B. By way of nonlimitingexample, the first and second adapters 1100, 1200 are reversibly (e.g.,releasably connected), such as, by being threaded together, by beingfriction fitted, through detent action or, as illustrated in FIG. 32,via snap fitting. To enable or facilitate the snap fitting connectionbetween the first adapter 1100 and the second adapter 1200, and again asshown in FIG. 32, the first adapter can include a circumferential ridge1140 beneath which first and second connection members 1210, 1220 of thesecond adapter can snap fit. By virtue of the design of the first andsecond adapters and further due to the snap fitting connection therebetween, the second adapter 1200 generally is at least partially,substantially, or entirely (i.e., 360°) rotatable while it is connectedto the first adapter 1100.

Techniques for achieving the releasable connection between the firstadapter 1100 and the second adapter 1200 include, but are not limitedto, providing the second adapter with recesses within which fingers orother protruding portions of the first adapter can fit (e.g., via snapfitting or detent), or by providing the second adapter with aplunger-like mechanism to expand inwardly or outwardly following apredetermined action (e.g., upon the pressing of a button or uponactivation of a trigger) in order to hold or release the first adapterin/from tactile communication with the second adapter.

Alternatively, the first adapter 1100 can be adapted to include anelastomeric lip in lieu of the radial seal 1120, in which case thesecond adapter can include a flanged portion to fit over the elastomericlip. This alternative embodiment also will allow for the second adapter1200 to be at least partially, substantially, or entirely (i.e., 360°)rotatable while it is connected to the first adapter 1100 and may bemore resistant to plastic deformation than the snap fitting and may alsofurther deter the formation of unwanted dirt and debris between thefirst adapter 1100 and the second adapter 1200.

In order to further reduce the accumulation of unwanted foreign matterand materials such as dust, dirt or debris (collectively referred toherein as “contaminants”), at least one screening/filtering componentcan be disposed within the second adapter 1200 at a predeterminedposition located within the path of air. In accordance with an exemplaryembodiment, and as shown in FIGS. 31B and 32, a plurality of screeningcomponents 1280 can be disposed within one, or, as is currentlypreferred, both of a first chamber 1270A and a second chamber 1270B ofthe second adapter 1200. As best shown in FIG. 30B, one or morescreening components 1280 also can be included within the single chamber1260 of the embodiment of the second adapter 1200 shown in FIGS. 30A and30B. In each instance, the presence of the one or more screeningcomponents 1280 beneficially prevents, or at least substantially reducesthe possibility of contaminants that may be present within the cuff 1000from entering, let alone traveling through the second adapter 1200.

The one or more screening components 1280 can have the same shape anddimensions, or can have varied dimensions and/or shape (e.g., variedheight and/or width). However, as shown in FIG. 32, each screeningcomponent 1280 generally is a substantially cylindrically shaped member.This is generally the case whether the screening component(s) 1280 arepresent in a second adapter 1200 of the type shown in FIGS. 30A and 30Bor a second adapter of the type depicted in FIGS. 31A and 31B. The oneor more screening components 1280 can be connected or attached to theirplacement locations within the second adapter 1200 via a variety ofknown attachment techniques, e.g., by being molded directly into thesecond adapter and/or through the use of an adhesive.

The exact number of screening components 1280 present within the secondadapter 1200 can vary; however, there should be enough such that thesecond adapter remains readily air permeable, yet also such thatcontaminants are reliably collected therein. In an embodiment wherein aplurality of screening components 1280 are located within both the firstand second chambers 1270A, 1270B of a second adapter 1200 of the typeshown in FIGS. 31A and 31B, the number in each chamber can vary as well,e.g., based on the size and/or shape of the screening components, thedimensions of the chambers, etc. However, according to an exemplaryembodiment of the present invention, the same numbers of screeningcomponents are disposed within each of the first chamber 1270A and thesecond chamber 1270B. Generally, the number of screening components 1280within each chamber 1270A, 1270B can range from five to fifteen.

A total of ten screening components 1280 are present within the singlechamber 1260 in FIG. 30B. However, the total number of screeningcomponents in the single chamber 1260 of a second adapter 1200 of thetype shown in FIGS. 30A and 30B can vary above or below ten, e.g., basedon the size and/or shape of the screening components, the dimensions ofthe single chamber, etc.

The screening component(s) 1280 should be made from at least onematerial that reliably collects contaminants, yet that does nototherwise inhibit the passage of air through the second adapter 1200 soas not to deter or prevent the functioning of a blood pressuremeasurement system within which the second adapter is incorporated. Tothat end, and by way of non-limiting example, the screening component(s)1280 can be formed of a mesh material (e.g., wire screen, a clothmaterial, or a plastic material) or a membrane (e.g., a membrane of asintered material, a fibrous material or a fabric). Each of the one ormore screening components 1280 can be made from the same or from adifferent material.

By virtue of being made of a mesh or membrane, the one or more screeningcomponents 1280 are at least partially self-cleaning, wherein suchcleaning occurs by reverse direction air flow from the first adapter1100 into the second adapter 1200. Alternatively, any or all of the oneor more screening components 1280 can be cleaned or replaced on aperiodic or scheduled basis, wherein access to the screening componentsis gained by disconnecting, detaching or otherwise separating the secondadapter 1200 from the blood pressure measurement system and then openingthe second adapter.

It should be noted that although FIGS. 30B, 31B and 32 depict the one ormore screening components 1280 as being part of the second adapter 1200,it is also possible for one or more screening components to be locatedelsewhere within the blood pressure measurement system (e.g., within oras part of the first adapter 1100) in lieu of or in addition to the oneor more screening components that are included within the secondadapter. Moreover, the specific location of the one or more screeningcomponents 1280 within the second adapter 1200 could be changed from thedepicted locations, if desired, without undue experimentation.

As depicted in FIGS. 30A, 31A, 32 and 33, and in accordance with anoptional embodiment of the present invention, a covering element ormember 1300 can be releasably connected to a top opening of the mainbody 1205 of the second adapter 1200. Such connection can be made, byway of non-limiting example, by snap fitting first and second connectionmembers 1310, 1320 of the covering element 1300 under acircumferentially protruding ridge 1230 of the second adapter (see FIG.32). If present, the covering member 1300 generally serves only anaesthetic purpose and, to that end, can bear of textual and/or pictorialindicia, e.g., indicia relating to the manufacturer of the equipmentutilized in connection with the system.

Referring now to FIGS. 30A and 30B, an exemplary embodiment of thesecond adapter 1200 of the present invention is illustrated in detail.The second adapter 1200 of FIGS. 30A and 30B includes a main body 1205,as well as a single barb 1240 that protrudes from the main body. Asshown in FIG. 30B, a single chamber 1260 defined within the interior ofthe main body 1205 of the second adapter 1200 is in direct fluidcommunication with interior of the barb 1240. Therefore and once thefirst adapter 1100 has been connected to the second adapter 1200 asshown in FIG. 30C, the single chamber 1260 is in direct fluidcommunication with the opening 1110 of the first adapter. And becausethe opening 1100 defined within the main body 1105 of the first adapter1100 is in direct communication with the interior chamber of the cuff1000, the second adapter 1200 is in communication with the interiorchamber of the cuff A section of hose or tubing can be connected to thebarb 1240, as will be described in greater detail below, tointerchangeably provide fluid communication between the interior chamberof the cuff 1000 and a number of different blood pressure measurementdevices.

Another exemplary embodiment of the second adapter 1200 is illustratedin FIGS. 31A and 31B. The size, structure and components of the secondadapter 1200 of FIGS. 31A and 31B are generally identical to those ofthe second adapter depicted in FIGS. 30A and 30B. Two barbs 1250A, 12508protrude from the main body 1205 of the second adapter depicted in FIGS.31A and 31B, as opposed to the single barb design of the second adapterof FIGS. 30A and 30B. The barbs 1250A, 1250B extend from. one side ofthe main body 1205 of the second adapter 1200 and are identicalaccording to this embodiment. The barbs 1250A, 1250B are spaced apartfrom one another to permit hosing to be attached, as described below.Also, whereas the FIGS. 30A and 30B second adapter 1200 includes only asingle chamber 1260 in direct contact with its barb 1240, the FIGS. 31Aand 31B second adapter includes a first chamber 1270A, a second chamber1270B and a dividing zone 1270C defined there between. Both the firstand second chambers 1270A 1270B are in communication with the opening1110 of the first adapter 1100 once the first adapter has been connectedto the second adapter 120 of FIGS. 31A and 31B, however, the firstchamber 1270A is in direct fluid communication with the first barb1250A, but not the second barb 1250B, and the second chamber 1270B is indirect fluid communication with the second barb 1250B but not the firstbarb 1250A.

In accordance with the FIGS. 31A and 31B embodiment of the secondadapter 1200, and once the first adapter 1100 has been connected to thesecond adapter, the first and second chambers 1270A, 1270B are in directfluid communication with the opening 1110 of the first adapter. Andbecause the opening 1100 defined within the main body 1105 of the firstadapter 1100 is in direct communication with the interior chamber of thecuff 1000, the second adapter 1200 is in communication with the interiorchamber of the cuff. A quantity of hose or tubing having a female endalso can be attached or connected to the barbs 1250A, 1250B of the FIGS.31A and 31B second adapter 1200, as will be described in greater detailbelow, to provide fluid communication between the cuff 1000 and a bloodpressure measurement device.

It is understood that the FIGS. 30A and 30B embodiment of the secondadapter 1200 can be adapted to include one recess in lieu of one barb1240 and the FIGS. 31A and 31B embodiment of the second adapter can beadapted to include two recesses in lieu of the two barbs 1240A, 1240B orto replace one of the barbs with a recess, wherein the presence of therecess(es) will allow for attachment or connection of a quantity of hoseor tubing having a male end.

As shown in FIGS. 33-35, the presence of the second adapter 1200 enablesinterchangeable, individual connection between the cuff (via the firstadapter) and any of a plurality of blood pressure measuring devices.Such connection generally will be completed occur by attaching an end ofat least one hose to the protruding barb 1240 of the second adapter ofFIGS. 30A and 30B or to the protruding barbs 1250A, 1250B of the secondadapter 1200 of FIGS. 31A and 30B. In other words, if, as shown in FIG.33, the hose 1400 to be attached is defined by a two lumen 1410A, 1420Aconfiguration, then a second adapter 1200 having two barbs 1250A, 1250Bof the type shown in FIGS. 31A and 31B is utilized. If, instead, thehose 1400 has only a single lumen 1410 configuration, as depicted inFIG. 34, then a second adapter 1200 having one barb 1240 of the typeshown in FIGS. 30A and 30B would be utilized.

The present invention is highly advantageous in that it allows forswitching between single lumen 1410 and multiple lumen (e.g., dual lumen1410A, 1410B) hose attachments 1400 without necessitating removal of thecuff 1000, and with a minimum of added effort. For example, a secondadapter 1200 having one barb 1240, as shown in FIGS. 30A and 30B, may beconnected to the first adapter 1100 if a patient's blood pressure is tobe measured by a blood pressure measurement device that requirescommunication with a cuff 1000 via a hose 1400 having only one lumen1410. If, earlier or subsequently, the patient's blood pressure must bemeasured by a blood pressure measurement device that requirescommunication with a cuff 1000 via a hose 1400 having two lumens 1410A,1410B, then a second adapter 1200 having two barbs 1250A, 1250B, asshown in FIGS. 31A and 31B, may be connected to the first adapter 1100.Therefore, in accordance with the present invention, rather thanrequiring replacement of the entire cuff 1000 in order to allow forblood pressure measurements to be performed through use of differentequipment/devices that require communication with the cuff via differenthose attachments having different numbers of lumens, all that isnecessary, at most, is to replace the attached hose 1400 and/or thesecond adapter 1200.

The preceding interchangeability feature is highly beneficial because itis not uncommon for the same patient to require his or her bloodpressure to be measured by several different blood pressure measurementequipment or devices, wherein at least some of those devices requirehose attachments having a different number of lumens to be connectedthereto. Similarly, this interchangeability also is applicable tosituations in which multiple patients, each of which is wearing a cuffthat might be of a different size and/or type than as the other, seek tohave blood pressure measurements performed by one or more piece of bloodpressure measurement equipment. To these ends, exemplary FIG. 35illustrates three exemplary, removable single lumen hose attachments1510, 1520, 1530 and three exemplary, removable dual lumen hoseattachments 1610, 1620, 1630, wherein each of the six hose attachmentsis capable of being individually, releasably connected to one or moredifferent electronic blood pressure measurement devices (not shown).Generally, and as shown in FIG. 35, each of the hose attachments1510-1530, 1610-1630 is attached to an electronic blood pressuremeasurement device through use of a connector, wherein the specificchoice of connector will depend on the type and/or manufacturer of theblood pressure measurement device. For the single lumen hose attachments1510-1530, exemplary connectors include, but are not limited to, ascrew/luer type connector 1710, a locking type connector 1720, a bayonettype connector 1730, and a barb type connector (not shown). For duallumen hose attachments 1610-1630, exemplary connectors include, but arenot limited to, a screw/luer type connector 1810, a luer lock typeconnector 1820, a locking type connector 1830, and a barb type connector(not shown).

By way of non-limiting example, the single lumen hose attachment 1510shown in FIG. 3 5 can be connected at its first end 1900 to the barb1240 of the second adapter 1200 shown in FIGS. 30A and 30B and can befitted with a screw type connector 1710 to individually connect thesecond end 1910 of the hose attachment 1510 to blood pressuremeasurement devices such as a Welch Allyn Spot vital signs device, or aWelch Allyn VSM Series device, or a Welch Allyn Atlas Monitor, each ofwhich is commercially available from Welch Allyn, Inc. of SkaneatelesFalls, N.Y. USA. Also by way of non-limiting example, the single lumenhose attachment 1520 shown in FIG. 35 can be connected at its first end1920 to the barb 1240 of the second adapter 1200 shown in FIGS. 30A and30B and can be fitted with a locking type connector 1620 to individuallyconnect the second end 1930 of the hose attachment 1520 to bloodpressure measurement devices such as the Propaq vital signs monitorcommercially manufactured by Welch Allyn Protocol, Inc. of Beaverton,Oreg. USA. Still, also by way of non-limiting example, the single lumenhose attachment 1530 shown in FIG. 35 can be connected at its first end1940 to the barb 1240 of the second adapter 1200 shown in FIGS. 30A and30B and can be fitted with a bayonet type connector 1730 to individuallyconnect the second end 1950 of the hose attachment 1530 to bloodpressure measurement devices commercially available from AgilentTechnologies of Palo Alto, Calif. USA, by Spacelabs of Redmond, Wash.USA, by Datascope of Montvale, N.J. USA, Siemens AG of Munich, GERMANY,and by Criticare Systems, Inc. of Waukesha, Wis. USA. By way of stillfurther non-limiting example, the dual lumen hose attachment 1610 shownin FIG. 35 can be connected at its first end 2000 to the barbs 1250A,1250B of the second adapter 1200 shown in FIGS. 31A and 31B and can befitted with a screw type connector 1810 to individually connect thesecond end 2010 of the hose attachment 1610 to blood pressuremeasurement devices such as a Welch Allyn Spot Ultra vital signs device,which is commercially available from Welch Allyn of Skaneateles Falls,N.Y. USA, or to a Critikon Dynamap Monitor, which is commerciallyavailable from DRE Medical Incorporated of Louisville, Ky. USA. By wayof yet still further example, the dual lumen hose attachment 1620 shownin FIG. 35 can be connected at its first end 2020 to the barbs 1250A,1250B of the second adapter 1200 shown in FIGS. 31A and 31B and can befitted with a luer lock type connector 1820 to individually connect thesecond end 2030 of the hose attachment 1620 to blood pressuremeasurement devices commercially available from Datascope of Montvale,N.J. USA and Colin Medical Instruments Corp of San Antonio, Tex. USA. Byway of yet still even further non-limiting example, the dual lumen hoseattachment 1630 shown in FIG. 35 can be connected at its first end 2040to the barbs 1250A, 1250B of the second adapter shown in FIGS. 31A and31B and can be fitted with a locking type connector 1830 to individuallyconnect the second end 2050 of the hose attachment 1630 to bloodpressure measurement devices such as GE Marquette monitors, which arecommercially available from GE Healthcare of Waukesha, Wis. USA.

FIG. 35 further shows three (3) additional dual lumen hose attachments1640, 1650, 1660 that can be individually, releasably connected to oneor more manual blood pressure measurement devices. For example, the hoseattachment 1640 is defined by a first end 2060 and an opposing secondend 2065, the firmer including first and second lumens 1410A, 1410B. Thefirst end 2060 of the hose attachment 1640 is connected to the secondadapter 1200 shown in FIGS. 31A and 31B. The second end 2065 of thefirst lumen 1410A is adapted for connection to a hand-held pneumaticbulb 2100, whereas the second end of the second lumen 1410B is adaptedfor connection, e.g., via a luer lock connector, to a gauge (e.g., ahand gauge). By way of non-limiting example, the hose attachment 1640can be individually connected to the classic pocket, SRC pocket and wallmodel manual blood pressure measurement devices, commercially availablefrom Welch Allyn, Inc. of Skaneateles Falls, N.Y. USA. The hoseattachment 1650 is identical to the hose attachment 1640, except thatthe second end 2070 of the first lumen 1410A of the hose attachment 1650is designed to be connected to a larger bulb 2110 than the second end2065 of the first lumen 1410A of hose attachment 1640. The hoseattachment 1650 can be individually connected to at least the samemanual blood pressure measurement devices at hose attachment 1640. Hoseattachment 1660 also has a first end 2080 and a second end 2085 andincludes first and second lumens 1410A, 1410B. The first end 2080 of thehose attachment 1660 is connected to the second adapter 1200 shown inFIGS. 31A and 31B. The second end 2085 of the first lumen 1410A isadapted for connection to a disposable hand pneumatic bulb 2120, whereasthe second end of the second lumen 1410B is adapted for connection, viaa screw connector 1850, to a gauge (e.g., a hand gauge). By way ofnon-limiting example, the hose attachment 1630 can be individuallyconnected to various disposable inflation systems commercially availablefrom Welch Allyn, Inc. of Skaneateles Falls, N.Y. USA.

FIG. 35 further depicts three additional embodiments 2200, 2300, 2400 ofa single lumen system wherein the hose portions 2210, 2310, 2410 can beeither releasably or non-releasably attached to an adapter 2400, whichis releasably connectable to the first adapter 1100 as shown in FIG. 34.Each of the systems 2200, 2300, 2400 is similar in its design andfunction and are described in more detail in U.S. Pat. Nos. 6,796,186,6,746,406, 6,615,666, 6,578,428, 6,481,291, 6,422,086, each of which isincorporated by reference in its entirety herein.

During use of system 2200, the second end 2220 of the hose portion 2210is connected to a small sized, manually operated pneumatic bulb 2500.The system 2200 can be utilized, by way of non-limiting example, inconnection with the DS44 series of blood pressure measurement devicescommercially available from Welch Allyn, Inc. of Skaneateles, N.Y. USA.During use of system 2300, the second end 2320 of the hose portion 2310is connected to a large sized bulb 2510. The system 2300 can beutilized, by way of non-limiting example, in connection with the DS45and the SRC integrated series of blood pressure measurement devicescommercially available from Welch Allyn, Inc. of Skaneateles, N.Y. USA.During use of system 2400, the second end 2420 of the hose portion 2410is connected to a disposable bulb 2520. Like the system 2300, the system2400 also can be utilized, by way of non-limiting example, in connectionwith the DS45 and the SRC integrated series of blood pressuremeasurement devices commercially available from Welch Allyn, Inc. ofSkaneateles, N.Y. USA. [00165)

Referring once again to FIG. 29, the interchangeability of the presentinvention is highlighted by the depiction of three systems 2600, 2700,2800, each of which can be interchangeably connected to the firstadapter 1100 to be placed in direct fluid communication with theinterior chamber of the cuff. The first system 2600 is of the typedescribed above and depicted in FIG. 35 with reference numerals 2200,2300 and 2400 and can be individually connected to a variety of bloodpressure measurement devices, such as the DS44 series, DS45 seriesand/or SRC integrated series of blood pressure measurement devicescommercially available from Welch Allyn, Inc. of Skaneateles, N.Y. USA.The second system 2700 includes a second adapter 1200 of the typedepicted in FIGS. 30A and 30B wherein a first end of hose attachment1400 having a single lumen 1410 has been connected to the second adapterand wherein a screw type connector 1710 has been connected to the secondend of the hose attachment to enable the system 2700 to be individuallyconnected to different blood pressure measurement equipment than thesystem 2600, e.g., a Welch Allyn Spot vital signs device, or a WelchAllyn VSM Series device, or a Welch Allyn Atlas monitor, each of whichis commercially available from Welch Allyn, Inc. of Skaneateles Falls,N.Y. USA. The third system 2800 includes a second adapter 1200 of thetype depicted in FIGS. 31A and 31B wherein a first end of hoseattachment 1400 having a dual lumen 141 OA, 1410B has been connected tothe second adapter and wherein a screw type connector 1810 has beenconnected to the second end of the hose attachment to enable the system2800 to be individually connected to different blood pressuremeasurement equipment than the systems 2600, 2700, e.g., a Welch AllynSpot Ultra vital signs device, which is commercially available fromWelch Allyn of Skaneateles Falls, N.Y. USA, or to a Critikon Dynamapmonitor, which is commercially available from DRE Medical Incorporatedof Louisville, Ky. USA.

Thus, the system defined by the present invention is highly versatileand efficient in that it enables the same inflatable cuff 100 to remainconnected to a patient while blood pressure measurements can be made bydifferent blood pressure measurement equipment from one or moremanufacturers regardless of the differences (e.g., manual versuselectronic, single lumen hose attachment(s) versus dual lumen hoseattachment(s), screw connector versus luer connector versus lockingconnector versus barb connector versus bayonet connector, etc.) amongthe equipment. Still additional versatility and efficiency is provideddue to the system of the present invention being equally applicable toenable one or more blood pressure measurements to be taken from multiplepatients, each of whom is wearing a cuff that may be of a different sizeand/or type than the other, via one or more pieces of blood pressuremeasurement equipment. These are important advantages over the currentapproach, which, in order to conduct different types of blood pressuremeasurement on one or more patients using different blood pressuremeasurement equipment or devices, necessitates devoting comparativelymore time and manpower in order to attach an initial cuff, remove theinitial cuff, then locate and attach a new cuff or to find the necessaryconnections to enable such measurements to occur in each instance. Thebenefits of the present invention will be especially pronounced in ahospital, trauma center or HMO environment, in which there is often aneed to measure the blood pressure or one or more patients usingdifferent techniques and/or equipment, and where there can besignificant adverse consequences due to lost time and/or overtaxedmanpower.

PARTS LIST FOR FIGS. 1-35

-   10 blood pressure measuring device or apparatus-   12 gage housing-   12B gage housing-   14 interior cavity-   16 circumferential inner wall-   18 open top end-   19 reflexed portion-   20 bottom end-   20B bottom end-   21 outer edge (support plate)-   22 bubble or viewing window-   24 downwardly extending portion-   26 bottom opening-   28 horizontal support plate-   28A horizontal support plate-   30 top facing side-   32 bottom facing side-   34 central through opening-   36 sleeve-   36A sleeve-   36B sleeve-   40 movement mechanism-   42 diaphragm subassembly-   44 diaphragm-   44B diaphragm-   45 circumferential ridge-   46 O-ring-   46B O-ring-   47 outer edge-   47B outer edge-   48 pan-   49 wave-like surfaces-   49B wave-like surfaces-   50 cavity-   51 cavity-   52 contact surface-   53 lower end-   54 axially displaceable shaft member-   55 bottom end-   56 tubular member-   57 top end-   58 top cap portion-   59 end-ribbon spring-   61 end-ribbon spring-   62 indicating member-   63 dial face-   63A dial face-   65 O-ring-   66 threads-   67 slot-   68 biasing spring-   68B biasing spring-   69 recess-   70 ribbon spring member-   72 one end-   73 threads-   75 threads-   80 shoulder-   82 docking hub-   114 circumferential groove-   118 O-ring-   140 gage or instrument housing-   142 cuff-   144 sleeve portion-   146 sleeve portion-   148 inner volume-   152 upper housing portion-   154 lower housing portion-   156 intermediate portion-   158 interior cavity-   162 slot-   165 support plate-   166 detachable stethoscope adapter-   167 dial face-   170 arm-   171 movement mechanism-   174 extending attachment portion-   176 port-   178 hose-   180 female connector-   184 port-   190 socket-   194 instrument or gage housing-   196 ball-shaped engagement end-   198 direction-   200 opening-   202 peripheral bumper-   206 ridge-   210 gage housing-   212 upper housing portion-   214 movement mechanism-   218 narrowed lower housing portion-   220 engagement or mating end-   222 socket-   224 end opening-   226 blood pressure sleeve or cuff-   228 socket opening-   232 rubberized peripheral guard or bumper member-   234 stepped portion-   236 gap-   240 ribbon spring-   242 axially displaceable shaft member-   246 contained diaphragm-   248 indicating member-   250 circumferential channel-   260 gage housing-   264 upper housing portion-   268 narrowed lower housing portion-   270 engagement end-   271 end opening-   272 circular face groove-   274 movement mechanism-   276 bottom surface-   280 rubberized guard member-   284 radially extending portion-   285 rubberized shim-   286 au gap-   288 au gap-   289 O-ring-   290 axially extending portion-   292 movement mechanism-   294 gage housing-   296 gage housing-   297 threaded end-   298 inlet port-   299 bottom opening-   300 port-   302 cap-   304 opening-   305 tubular member-   306 gage housing-   307 pneumatic bulb-   308 opening-   309 output end-   310 inlet port-   320 socket-   324 sleeve-   328 interior-   340 blood pressure measuring apparatus-   344 sleeve-   348 gage housing-   352 barb or port-   356 pneumatic bulb-   360 tubing-   364 check valve-   368 sleeve portion-   372 sleeve portion-   375 patient-   376 hook and loop fastener portion-   380 artery index marker-   384 indicia-   388 indicia-   400 blood pressure measuring assembly-   404 sleeve-   408 port-   412 openrng-   416 interior, sleeve-   420 gage housing-   424 proximal end-   432 electronic movement mechanism-   434 pneumatic bulb-   438 hose-   442 coupling-   445 hook and loop fasteners-   446 bleed valve-   450 capacitance transducer assembly-   454 capacitance pressure sensor transducer-   458 oscillator circuit-   462 measurement and processing circuit-   466 counter circuit-   470 data processor-   474 reference oscillator-   475 I/O devices-   476 actuable button-   478 display-   480 metallic conductor layer-   484 circuit board-   488 ground conductor layer-   492 side-   496 metal ring-   500 pms-   504 ring conductor-   508 support plate-   512 metallic diaphragm-   516 O-ring-   520 snap-on cap-   522 port-   524 multiple snaps-   530 inverter gate-   534 inverter gate-   538 resistor-   540 capacitance transducer-   542 capacitor 544 capacitor-   548 low pass filter-   552 inverter gate-   556 resistor-   560 electronic gage module-   564 housing body-   566 upper or major housing section-   568 proximal engagement portion-   572 opening, end-   576 peripheral bumper-   582 capacitance transducer sensor assembly-   584 LCD-   586 circuit board-   588 viewing window-   594 processor-   598 button-   600 batteries-   640 electronic gage housing or module-   644 housing body-   648 valve-   652 pressure-sensitive switch-   656 sensor-   660 port-   666 processor-   670 display-   674 wireless link-   1000 cuff-   1010 exterior surface-   1030 opening-   1050 indicia-   1100 first adapter-   1105 main body-   1110 opening-   1120 radial seal-   1130 rmg-   1140 ridge-   1150 interfacing portion-   1200 second (additional) adapter-   1205 main body-   1210 first connection member-   1220 second connection member-   1230 ridge-   1240 barb-   1250A barb-   1250B barb-   1260 single chamber-   1270A first chamber-   1270B second chamber-   1270C channel-   1280 screening component-   1300 covering element-   1310 first connection element-   1320 second connection element-   1400 hose/hose attachment-   1410 single lumen-   1410A first lumen-   1420B second lumen-   1510 single lumen hose attachment-   1520 single lumen hose attachment-   1530 single lumen hose attachment-   1610 dual lumen hose attachment-   1620 dual lumen hose attachment-   1630 dual lumen hose attachment-   1640 dual lumen hose attachment-   1650 dual lumen hose attachment-   1660 dual lumen hose attachment-   1710 screw type connector-   1720 locking type connector-   1730 bayonet type connector-   1810 screw type connector-   1820 luer lock type connector-   1830 locking type connector-   1900 first end of hose attachment-   1910 second end of hose attachment-   1920 first end of hose attachment-   1930 second end of hose attachment-   1940 first end of hose attachment-   1950 second end of hose attachment-   2000 first end of hose attachment-   2010 second end of hose attachment-   2020 first end of hose attachment-   2030 second end of hose attachment-   2040 first end of hose attachment-   2050 second end of hose attachment-   2060 first end of hose attachment-   2065 second end of hose attachment-   2070 first end of hose attachment-   2075 second end of hose attachment-   2080 first end of hose attachment-   2085 second end of hose attachment-   2100 bulb-   2110 bulb-   2120 bulb-   2200 first attached adapter and hose system-   2210 hose portion-   2220 second end-   2300 second attached adapter and hose system-   2310 hose portion-   2320 second end-   2400 third attached adapter and hose system-   2410 hose portion-   2420 second end-   2500 bulb-   2510 bulb-   2520 bulb-   2600 first exemplary system-   2700 second exemplary system-   2800 third exemplary system

Although the present invention has been described herein with referenceto details of currently preferred embodiments, it is not intended thatsuch details be regarded as limiting the scope of the invention, exceptas and to the extent that they are included in the following claims—thatis, the foregoing description of the present invention is merelyillustrative, and it should be understood that variations andmodifications can be effected without departing from the scope or spiritof the invention as set forth in the following claims. Moreover, anydocument(s) mentioned herein are incorporated by reference in theirentirety, as are any other documents that are referenced within thedocument(s) mentioned herein.

The invention claimed is:
 1. A cuff configured to be wrapped about alimb of a patient for conducting blood pressure measurements, the cuffcomprising: an inflatable chamber; an external surface; and a firstadapter connected to the inflatable chamber, the first adapterincluding: a main body having an opening providing direct fluidcommunication between the external surface and the inflatable chamber,wherein the opening is defined by an inner diameter of the main body,the inner diameter of the main body being configured to form afriction-fit with an outer diameter of a second adapter releasablyattachable to the first adapter, wherein the main body further includesa ridge extending radially away from the opening, the ridge beingconfigured such that a distalmost portion of the second adapter isdisposed radially inward of the ridge when the inner diameter of themain body forms the friction-fit with the outer diameter of the secondadapter.
 2. The cuff of claim 1, wherein the first adapter includes acircumferential seal configured to form a substantially fluid-tight sealwith the outer diameter of the second adapter when the second adapter isreleasably attached to the first adapter.
 3. The cuff of claim 2, thecircumferential seal having an inner diameter that is less than theinner diameter of the main body, the inner diameter of thecircumferential seal forming the substantially fluid-tight seal with theouter diameter of the second adapter when at least part of the secondadapter is disposed proximal to and radially inward of the opening, andthe distalmost portion of the second adapter being disposed radiallyinward of the ridge when the inner diameter of the circumferential sealforms the substantially fluid-tight seal with the outer diameter of thesecond adapter.
 4. The cuff of claim 2, wherein: a proximal end of themain body is disposed at the inflatable chamber; a distal end of themain body is disposed opposite the proximal end, and is configured toaccept the outer diameter of the second adapter; and a distalmostportion of the circumferential seal is disposed proximal to the distalend of the main body.
 5. The cuff of claim 2, wherein thecircumferential seal includes an inner diameter that is less than aninner diameter of the opening, the circumferential seal furtherincluding an outer diameter that is greater than the inner diameter ofthe opening.
 6. The cuff of claim 1, wherein the main body includes aportion forming at least part of the opening, and a flange extendingfrom the portion and connecting the first adapter to one of theinflatable chamber and the external surface.
 7. The cuff of claim 6,wherein the portion is made of a first material and the flange is madefrom a second material having a different flexibility than the firstmaterial.
 8. A cuff configured to be wrapped about a limb of a patientfor conducting blood pressure measurements, the cuff comprising: aninflatable chamber; an external surface; a first adapter connected tothe inflatable chamber, the first adapter including a main body havingan opening providing direct fluid communication between the externalsurface and the inflatable chamber, wherein the opening is defined by aninner diameter of the main body; and a circumferential seal having aninner diameter, the inner diameter of the circumferential seal beingconfigured to form a substantially fluid-tight seal with an outerdiameter of a second adapter releasably attachable to the first adapterwhen at least part of the second adapter is disposed proximal to andradially inward of the opening, wherein the main body further includes aridge extending radially away from the opening, the circumferential sealand the ridge being configured such that a distalmost portion of thesecond adapter is disposed radially inward of the ridge when the innerdiameter of the circumferential seal forms the substantially fluid-tightseal with the outer diameter of the second adapter.
 9. The cuff of claim8, wherein: a proximal end of the main body is disposed at theinflatable chamber; a distal end of the main body is disposed oppositethe proximal end, and is configured to accept the outer diameter of thesecond adapter; and a distalmost portion of the circumferential seal isdisposed proximal to the distal end of the main body.
 10. The cuff ofclaim 8, wherein the main body further includes a flange connecting thefirst adapter to one of the inflatable chamber and the external surface.11. The cuff of claim 8, wherein the opening comprises an opening of asubstantially cylindrical inner channel of the main body, the innerchannel extending from a distal end of the main body to a proximal endof the main body, the main body defining a longitudinal axis extendingsubstantially centrally through the inner channel.
 12. The cuff of claim11, wherein a portion of the external surface adjacent the main bodyextends substantially perpendicular to the longitudinal axis, and theinner channel is configured to guide movement of the at least part ofthe second adapter along the longitudinal axis in a directionsubstantially perpendicular to the portion of the external surface. 13.The cuff of claim 8, wherein at least a portion of the circumferentialseal extends into the opening.
 14. A cuff configured to be wrapped abouta limb of a patient for conducting blood pressure measurements, the cuffcomprising: an inflatable chamber; an external surface; a first adapterconnected to the inflatable chamber and configured to interface with asecond adapter releasably attachable to the first adapter, the firstadapter having a main body comprising a substantially cylindrical innerchannel, the inner channel extending from a distal end of the firstadapter to a proximal end of the first adapter, the inner channelincluding an opening providing direct fluid communication between theexternal surface and the inflatable chamber, wherein the main bodydefines a longitudinal axis extending substantially centrally throughthe inner channel and the opening, the longitudinal axis extendingsubstantially perpendicular to the external surface throughout the innerchannel; a circumferential seal disposed proximate the opening andhaving a diameter greater than a diameter of the inner channel, thecircumferential seal being configured to form a substantiallyfluid-tight seal with the second adapter when the second adapter isreleasably attached to the first adapter; and the main body furtherincludes a ridge extending radially away from the opening, the ridgebeing configured such that a distalmost portion of the second adapter isdisposed radially inward of the ridge when the inner diameter of themain body forms the friction-fit with the outer diameter of the secondadapter.
 15. The cuff of claim 14, the first adapter further including alip configured to engage the second adapter when the second adapter isreleasably attached to the first adapter.
 16. The cuff of claim 15,wherein the lip is made from a first material and at least part of thefirst adapter is made from a second material different from the firstmaterial.
 17. The cuff of claim 15, wherein the circumferential seal isin communication with the external surface of the cuff.
 18. The cuff ofclaim 15, wherein a single piece of material forms at least part of theexternal surface and the inflatable chamber, and the first adapter isconnected to the single piece of material.